摘要
目的探讨抗生素不同疗程及时机使用对子宫肌瘤术后血清炎症因子水平及不良反应的影响。方法选择2018-05-01-2021-05-31郑州万安妇产医院行子宫肌瘤切除术的96例患者作为研究对象。以信封法将患者随机分为3组,每组32例。所有患者均行开腹子宫肌瘤剔除术,A组在术后给予注射用头孢美唑钠1 g静脉滴入,2次/d,连续3 d;B组在术前30 min静脉注射头孢美唑钠1 g,术后给予注射用头孢美唑钠1 g静脉滴入,2次/d,连续3 d;C组在术后给予注射用头孢美唑钠1 g静脉滴入,2次/d,连续5 d。比较3组患者手术一般情况、切口愈合情况、感染情况、炎症因子及不良反应发生情况。结果3组患者手术时间、术中出血量、术后排气时间比较,差异无统计学意义,均P>0.05;A组住院时间为(5.18±1.07)d,B组为(5.25±1.13)d,C组为(6.25±1.49)d,A组>C组,B组>C组,差异有统计学意义,F=7.410,P=0.001。3组患者甲级愈合、乙级愈合及丙级愈合情况比较,差异无统计学意义,均P>0.05。A组总感染率为28.13%,C组总感染率为31.25%,均高于B组的6.25%,差异有统计学意义,χ^(2)=6.949,P=0.030;A组与C组的感染率差异无统计学意义,P>0.05。术前3组患者干扰素γ、白细胞介素-1及白细胞介素-8水平比较,差异无统计学意义,均P>0.05;术后A组干扰素γ水平为(6.41±1.73)ng/mL,B组为(5.18±1.39)ng/mL,C组为(6.25±1.81)ng/mL,均高于术前,且B组低于A组与C组,F=5.235,P=0.007;A组白细胞介素-1水平为(2.43±0.61)μg/mL,B组为(1.63±0.37)μg/mL,C组为(2.29±0.69)μg/mL,均高于术前,且B组低于A组与C组,F=17.788,P<0.001;A组白细胞介素-8水平为(95.86±21.06)μg/mL,B组为(80.63±16.91)μg/mL,C组为(91.05±18.25)μg/mL,均高于术前,且B组低于A组与C组,F=5.476,P=0.006。A组共出现3例(9.38%)不良反应,B组出现4例(12.50%),C组出现5例(15.63%),3组不良反应发生率比较,差异无统计学意义,P>0.05。结论子宫肌瘤术前30 min及术后给予注射用头孢美唑钠连续3 d治疗的抗菌、抗感染效果最好且不增加不良反应发生率。
Objective To investigate the effect antibiotics used in different courses and at different times on the level of serum inflammatory factors and adverse reactions after uterine.Methods A total of 96 patients who underwent myomectomy in Zhengzhou Wan’an Maternity and Obstetrics Hospital from May 1,2018 to May 31,2021 were selected for the study.The patients were randomly divided into 3 groups by envelope method,32 cases in each group.All patients underwent open hysteromyomectomy.In group A,1g of cefmetazole sodium for injection was given intravenously twice a day for 3 consecutive days after surgery.In group B,1 g of cefmetazole sodium was injected intravenously 30minutes before the operation,and 1g of cefmetazole sodium for injection was given intravenously after the operation,twice a day for 3 consecutive days.In group C,1g of cefmetazole sodium for injection was given intravenously twice a day for 5 days after operation.The general condition of operation,wound healing,infection,inflammatory factors and adverse reactions of the three groups were compared.Results There was no significant difference in operation time,intraoperative blood loss and postoperative exhaust time among the three groups(all P>0.05).The hospitalization time of group A was(5.18±1.07)days,that of group B was(5.25±1.13)days,and that of group C was(6.25±1.49)days,the difference was statistically significant(F=7.410,P=0.001).There was no significant difference among the three groups in terms of Class A,Class B and Class C healing(all P>0.05).The total infection rate of group A was 28.13%,and that of group C was 31.25%,both higher than 6.25%of group B,the difference was statistically significant,χ^(2)=6.949,P=0.030.There was no significant difference in the infection rate between group A and group C(P>0.05).There was no significant difference in the levels of interferonγ,interleukin-1 and interleukin-8 among the three groups before operation,all P>0.05.The levels of interferonγin group A,group B and group C were(6.41±1.73)ng/ml,(5.18±1.39)ng/ml and(6.25±1.81)ng/ml after operation,which were higher than those before operation,and the levels of interferonγin group B were lower than those in groups A and C(F=5.235,P=0.007).The levels of interleukin-1were(2.43±0.61)μg/ml in group A,(1.63±0.37)μg/ml in group B and(2.29±0.69)μg/ml in group C,which were higher than those before operation,and lower in group B than in groups A and C(F=17.788,P<0.001).The level of interleukin-8 was(95.86±21.06)μg/ml in group A,(80.63±16.91)μg/ml in group B and(91.05±18.25)μg/ml in group C,which were higher than those before operation,and lower in group B than in groups A and C(F=5.476,P=0.006).There were 3 cases(9.38%)of adverse reactions in group A,4 cases(12.50%)in group B,and 5cases(15.63%)in group C,there was no significant difference in the incidence of adverse reactions among the 3 groups,P>0.05.Conclusion Cefmetazole sodium injection 30min before operation and 3days after operation has the best antibacterial and antiinflammatory effects and does not increase the incidence of adverse reactions.
作者
陈月月
张梦真
苏玥辉
沈玲
CHEN Yue-yue;ZHANG Meng-zhen;SU Yue-hui;SHEN Ling(Department of Obstetrics and Gynecology,Wan'an Obstetrics and Gynecology Hospital,Zhengzhou 450000,China;Zhengdong District,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《社区医学杂志》
CAS
2022年第20期1159-1163,共5页
Journal Of Community Medicine
基金
河南省医学科技攻关计划(SB201901043)
关键词
子宫肌瘤
抗生素
疗程
使用时机
uterine fibroids
antibiotics
course of treatment
timing of use
