肝移植术后早期口腔并发症及深部真菌感染的预防  

Clinical Research of Prevention on Prophase Oral Cavity Infection and Deep Fungal Infection after Liver Transplantation

作　　者：李萌萌[1] 李荣华[2] 殷恺[2] 曹晓丽[2] 

机构地区：[1]天津医科大学,300070 [2]天津市第一中心医院口腔科

出　　处：《天津医药》2011年第6期511-513,共3页Tianjin Medical Journal

基　　金：天津市卫生局基金资助项目(项目编号:2010KZ29)

摘　　要：目的:观察研究口腔内局部联合用药预防肝移植术后早期口腔感染及深部真菌感染的临床效果。方法:将162例肝移植术后患者随机分为观察组A(57例)、观察组B(62例)和对照组(43例),观察组A采用3%碳酸氢钠溶液和0.1%西吡氯铵含漱液局部联合进行口腔干预,观察组B采用5×104U/mL制霉菌素水混悬液和0.1%西吡氯铵含漱液局部联合进行口腔干预,对照组常规采用生理盐水进行口腔干预。观察并记录患者术后口腔并发症,并进行血浆(1-3)-β-D葡聚糖水平检测。结果:3组口腔并发症和(1-3)-β-D葡聚糖水平差异均有统计学意义(P<0.05或P<0.01),其中观察组A与对照组牙龈红肿发生率组间差异有统计学意义,观察组B与对照组口腔溃疡、霉菌感染发生率差异有统计学意义,观察组A和观察组B之间口腔并发症和(1-3)-β-D葡聚糖水平差异无统计学意义(P>0.05)。结论:采用0.1%西吡氯铵含漱液分别与3%碳酸氢钠溶液或5×104U/mL制霉菌素水混悬液联合应用进行口腔干预对预防肝移植术后早期口腔并发症及深部真菌感染有临床意义。Objective：To observe the clinical effect of drug combination using in oral cavity on prevention of prophase oral infection and deep fungal infection after liver transplantation. Methods：One hundred and sixty-two patients with liver transplantation were randomly divided into observation group A （n=57）, observation group B （n=62） and control group（n=43）. For the group A, 3% sodium bicarbonate gargle and 0.1% cetylpyridinium chloride gargle were combinedly used to cavity nursing. For patients of group B, 5×10^4 U/mL nystatin aqueous suspension combinedly with 0.1% cetylpyridinium chloride gargle were used to oral nursing. For patients of control group only normal saline was used in nursing oral cavity. The oral complications were observed in patients of groups. The level of plasma （1-3）-β-D-glucan was detected. Results： There were significant differences in oral complications and （1-3）-β-D-glucan level between three groups （P 〈 0.05 or P 〈 0.01）. There was a significant difference in gingivitis between group A and control group（P 〈 0.05）. There were also significant differences in oral ulcer and mycoses between group B and control group（P 〈 0.05）. No significant differences were found in oral complications and （1-3）-β-D-glucan level between group A and group B （P 〉 0.05）. Conclusion： There were clinical significances of oral nursing by using 0.1% cetylpyridinium chloride gargle combined with 3% sodium bicarbonate gargle and 5×104 U/mL nystatin aqueous suspension respectively to prevent prophase oral infection and deep fungal infection after liver transplantation.

关 键 词：肝移植 手术后并发症 感染控制 口腔 细菌感染和真菌病 药物疗法 联合 西吡铵 碳酸氢钠 制霉菌素 

分 类 号：R473.73[医药卫生—护理学]