摘要
目的探讨高强度聚集超声消融术后抗生素应用的必要性。方法选取2019年8~12月因病行高强度聚集超声消融治疗的患者共100例,其中子宫肌瘤60例,子宫腺肌病25例,肌瘤合并腺肌病10例,瘢痕妊娠5例,随机分为观察组和对照组,每组50例。观察组术后应用阿莫西林预防感染治疗3 d,对照组术后不用药。术前均常规检查血常规、生化(包括CRP),治疗后第1天晨复查血常规、CRP、监测体温,观察患者术后反应,术后3 d回访,通过对术后炎性反应的指标监测,应用与未应用抗生素组患者的症状调查,探讨术后应用抗生素的必要性。结果通过术前检查、术后复查相关炎性指标及体温变化,发现高强度聚集超声消融后出现体温升高、炎性反应的患者发生率为3%,与患者术前存在高危因素(贫血、诊刮操作)有关,与投入能量大小、治疗时间有关,与肌瘤多少、操作时间长短、年龄无关(P>0.05),术前有诊刮及宫腔操作为高危因素者,术后感染风险增加(P<0.05),应预防应用抗生素,无高危因素者应用抗生素与否患者临床表现及检测指标无差别,不需要常规应用抗生素预防感染。结论高强度聚集超声消融治疗是一种无创安全有效的治疗方法,通过对病灶产生高温,使病灶发生凝固性坏死而起到治疗作用,这种治疗方式无明显引起组织发生炎性感染的倾向,术后无诊刮高危因素者不需常规口服抗生素预防感染。
Objective To investigate the necessity of antibiotic application after Haifu operation.Methods A total of 100 patients who were treated by Haifu operation in our hospital from August 2019 to December 2019 were enrolled in the study,including 60 cases of uterine fibroids,25 cases of adenomyosis,10 cases of fibroids with adenomyosis,and 5 cases of scar pregnancy.These patients were randomly divided into observation group and control group,with 50 cases ineach group.The patients in observation group were treated by amoxicillin for 3 days after operation,however,the patients in control group were not given medication after operation.The blood routine and biochemistry(including CRP)were routinely performed before operation.And the blood routine,CRP and body temperature were rechecked on the morning of the first day after treatment to observe the postoperative response of the patient.Moreover the follow up was perfomed at 3 days after the operation.The inflammatory reaction and symptomes after operation were observed and compared between the two groups.Results Through the preoperative examination and postoperative reexamination of relevant inflammatory indexes and temperature changes of patients,it was found that the incidence of patients with temperature increase and inflammatory reaction after Haifu operation was 3%,which was related to the high-risk factors(anemia,curettage operation),energy input,treatment time,however,which were not correlated with the myoma number,operation time and patient’s age(P>0.05).The preoperative uterine cavity operation increased the infection risk after operation(P<0.05).It was necessary to use antibiotics to prevent infection,however,it was not necessary to use antibiotics for the patients without high risk factors.Conclusion Haifu operation is an non-invasive,safe and effective treatment method,which can treat the focus of disease by producing high temperature,making the focus coagulate and necrotic.This treatment method has no obvious tendency to cause inflammatory infection of the tissue,and the patients without high-risk factors need not to take antibiotics to prevent infection.
作者
潘晓伟
史鹏飞
陈何伟
蔡玉茹
徐峰
PAN Xiaowei;SHI Pengfei;CHEN Hewei(Department of Gynecology,The People’s Hospital of Shijiazhuang City,Hebei,Shijiazhuang 050011,China)
出处
《河北医药》
CAS
2020年第24期3779-3781,3785,共4页
Hebei Medical Journal
