哌拉西林钠/他唑巴坦钠对胆管癌术后合并腹腔感染的疗效分析

摘要

目的 探讨哌拉西林钠/他唑巴坦钠对胆管癌术后合并腹腔感染的临床疗效.方法 回顾性分析78例行胆管癌手术且合并术后腹腔感染的胆管癌患者的临床资料,依据治疗方法的不同将患者分为观察组和对照组,每组39例.对照组患者接受常规胆管引流联合注射用头孢曲松钠及甲硝唑注射液并辅以其他常规治疗方案进行治疗,观察组患者接受注射用哌拉西林钠/他唑巴坦钠联合甲硝唑注射液进行治疗,余治疗措施同对照组;观察比较两组患者抗感染治疗前后的白细胞计数(WBC)、红细胞沉降率(ESR)、C反应蛋白(CRP)、降钙素原(PCT)、肿瘤细胞坏死因子-α(TNF-α)、内毒素、免疫水平及临床症状改善情况.结果 治疗前,两组患者的WBC、ESR、CRP、PCT、TNF-α、内毒素水平,以及CD3+、CD4+、CD8+、CD4+/CD8+水平比较,差异均无统计学意义(P﹥0.05).治疗后,观察组患者的WBC、ESR、CRP、PCT、内毒素水平均低于对照组患者,CD4+水平及临床症状(发热、乏力、腹痛)改善率均高于对照组患者,差异均有统计学意义(P﹤0.05).结论 哌拉西林钠/他唑巴坦钠分别联合甲硝唑注射液可有效改善胆管癌术后合并腹腔感染患者的临床症状,增强抗感染效果,并对患者的免疫系统功能恢复具有积极的作用.%Objective To explore the effect of piperacillin sodium/tazobactam sodium in patients with abdominal infection after cholangiocarcinoma surgery. Method 78 patients with cholangiocarcinoma who underwent surgical treatment and developed abdominal infection were assigned as study group or control group according to respective treatment methods, each group had 39 cases; the patients in control group were treated with conventional bile duct drainage combined with ceftriaxone sodium and metronidazole injection and supplemented by other routine treatment regimen, while patients in study group were administered with piperacillin sodium/tazobactam sodium combined with metronidazole injection,other treatment measures were the same as the control group.The white blood cell count(WBC), erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),procalcitonin(PCT),tumor necrosis factor-α(TNF-α), endotoxin, as well as the level of CD3+, CD4+, CD8+, CD4+/CD8+before and after the treatment were observed and compared between the two groups. Result There was no statistically significant difference in regard of WBC, ESR, CRP,PCT,TNF-α,endotoxin and CD3+,CD4+,CD8+,CD4+/CD8+levels between the two groups before treatment(P>0.05).The WBC,ESR,CRP,PCT and endotoxin levels in the study group were lower than those in the control group.The improvement rate of CD4+levels and clinical symptoms (fever, fatigue, abdominal pain) was higher than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The regimen of piperacillin sodium/tazobactam sodium instead of ceftriaxone sodium combined with metronidazole can effectively relieve the clinical symptoms of abdominal infection in patients after cholangiocarcinoma surgery, enhance the anti-infective effect, and it may also positively promote the recovery of immune system function.