纤维蛋白胶丁胺卡那霉素复合体防治深部创口感染  

Treatment of deep wound infection with fibrin glue amikacin complex

作　　者：马志坚[1] 杨洪昌[1] 陈仲[1] 吴兆翔[1] 李滔[1] 程刚[1] 廖鹏[1] 欧艺[1] 李灿章[1] 韩涛[1] 

机构地区：[1]云南省第二人民医院创伤外科,云南省创伤救治中心,昆明650021

出　　处：《中华创伤杂志》2009年第6期554-557,共4页Chinese Journal of Trauma

基　　金：基金项目：云南省科技攻关资助项目（2005NGO）

摘　　要：目的观察纤维蛋白胶丁胺卡那霉素复合体治疗深部创口后白细胞计数和中性粒细胞分类变化，探讨该复合体控制感染的有效性。方法采用临床病例对照研究方法进行研究。采用计算机随机摇号分组，将试验组100例患者与对照组100例患者按创口部位、大小、受伤到手术时间、合并损伤、全身应用抗生素配对分组，对比两组清创术后不同时间点白细胞计数和中性粒细胞分类计数变化，观察试验组有无与使用纤维蛋白胶丁胺卡那霉素复合体相关的毒副作用。结果（1）试验组和对照组在性别分布、平均年龄、受伤机制方面基本相同（P〉0．05），两组具有可比性。（2）试验组组内不同时间点白细胞计数和中性粒细胞分类计数差异有统计学意义（P〈0．05），术后1d白细胞计数和中性粒细胞分类计数最高，以后随着治疗时间延长而逐渐下降，术后24d或出院前1d最低。（3）试验组和对照组白细胞计数除术后1d差异无统计学意义（P〉0．05）外，其余时间点试验组均比对照组低（P〈0．05）。试验组和对照组术后不同时间点中性粒细胞分类计数比较，在术后1，2，12d两组差异无统计学意义（P〉0．05），其余时间点两组差异均有统计学意义（P〈0．05），试验组不同时间点中性粒细胞分类计数均比对照组低。结论纤维蛋白胶丁胺卡那霉素复合体治疗深部创口感染有较好的临床效果，安全性高，没有不良反应和毒副作用，值得推广使用。Objective To discuss the efficiency of fibrin glue amikacin complex in controlling infection by observing the changes of leukocyte and neutrophilic granulocyte classifying counts after fibrin glue amikacin complex treated deep wound. Methods Clinical case-control study was used in the study. All patients were divided randomly into test group （ 100 patients） and control group （ 100 patients）, matched by wound location, wound size, time from injury to operation, combined injury and general antibiotics use to compare leukocyte and neutrophilic granulocyte classifying counts between both groups and observe possible toxic and sideffect in test group. Results Firstly, the test group and control group had the comparability in aspects of gender distribution, average age and injury mechanism （P 〉 0. 05 ）. Secondly, there was statistical difference in classifying counts of leukocyte and neutrophilic granulocyte in the test group at different time points （ P 〈 0.05 ）. The classifying counts of leukocyte and neutrophilic granulocyte peaked at 24 hours after operation, then decreased with treatment time and reached the lowest at 24 days after surgery or at day 1 before discharge. Thirdly, there existed statistical significance upon leukocyte counts in the test group and control group except for at day 1 after operation （ P 〉 0. 05 ）, with lower counts in test group than control group. In aspect of neutrophil classifying counts, there was statistical significance （ P 〈 0. 05 ） at other time points in both groups except for time points at days 1, 2 and 12 （P 〉 0.05 ）. The test group had lower neutrophil classifying counts compared with control group at different time points. Conclusion The fibrin glue amikacin complex has good clinical effect and high security, with no toxic or side effect in treatment of deep wound infection, and is worth clinical applicaiton.

关 键 词：纤维蛋白胶组织黏着剂 丁胺卡那霉素类 伤口感染 白细胞 中性粒细 胞 胞 

分 类 号：R64[医药卫生—外科学]