肝硬化食管胃底静脉曲张出血患者预防性抗菌治疗的前瞻性研究

摘要

目的 前瞻性研究肝硬化曲张静脉破裂出血时,预防性应用抗生素对于止血、降低早期再出血率及减少院内感染的意义.方法 168例肝硬化曲张静脉破裂出血患者被随机分为抗生素预防治疗组87例和非预防组81例.结果 抗菌组与非抗菌组比,平均出血停止时间(16.7±13.6h/22.1±17.4h)、再出血发生率(8.1%/22.2%)、平均输血量(583.3±326.7ml/735.3±560.2ml)、院内感染发生率(13.8%/65.4%)、平均住院天数(11.5±4.3d/13.0±5.4d)、平均医疗费用(13807.0±3293.4元/15910.9±4632.2元)均明显缩短或减少;抗菌组病死率(4.6%)与非抗菌组(8.6%)比,无统计学差别.结论 预防性应用抗生素治疗肝硬化食管胃静脉曲张出血患者可明显获益.%Objective To study the prophylactic antibiotics in the treatment of patients with gastroesophageal variceal bleeding.Method 168 liver cirrhosis patients with gastroesophageal variceal bleeding were randomly assigned to the antibiotic prophylaxis group (n=87)and control group (n=81)without antibioticsResults There were statistical differences between the data in the antibiotic prophylaxis group and the control as respect to bleeding period(16.7± 13.6h va22.1± 17.4h),the incidence of rebleeding(8.1%/22.2%),the average amount of blood transfusion (564± 437ml/941± 482ml),the incidence of the nosocomial infection(13.8%/65.4%),the average hospitalization days (11.5± 4.3d/13.0± 5.4d)and the average hospital izati on costs (13807.0± 3293.4 yuan/15910.9± 4632.2 yuan); There was no statistical difference between the mortality (4.6% va8.6%)in the two groups Conclusion Using antibiotic prophylaxis in gastroesophageal variceal bleeding patients can draw a better outcomes.