中药腹腔灌洗在腹腔镜胆囊切除术中的应用价值  

Value of peritoneal lavage with traditional Chinese medicine in laparoscopic cholecystectomy

作　　者：冯刚[1] 戚仕均[1] 谢立江[1] 方泉[1] 

机构地区：[1]绍兴市中医院肝胆外科,浙江绍兴312000

出　　处：《中华医院感染学杂志》2013年第23期5729-5730,5764,共3页Chinese Journal of Nosocomiology

基　　金：浙江省中医药科技基金项目(2008A33011)

摘　　要：目的研究择期腹腔镜胆囊切除术患者术中应用中药腹腔灌洗,以达到替代围手术期抗菌药物的使用。方法将胆囊良性病变93例住院患者随机分为3组,每组31例,全麻下行择期腹腔镜胆囊切除术,按组别分别给予中药灌洗(A组)、抗菌药物静脉滴注加盐水灌洗(B组)和单纯盐水灌洗(C组)治疗,观察3组患者术后体温、感染发生率、肝功能变化、医疗费用等。结果中药灌洗组与抗菌药物静脉滴注加盐水灌洗组术后感染率分别为9.7%和6.5%,低于单纯盐水灌洗组(P<0.05);中药灌洗组和单纯盐水灌洗组医疗费用分别为(7.9±0.5)千元和(7.7±0.3)千元,低于抗菌药物静脉滴注加盐水灌洗组(9.1±0.5)千元,差异有统计学意义(P<0.05);中药灌洗组术后未观察到明显不良反应。结论择期腹腔镜胆囊切除术中可以用中药腹腔灌洗替代围手术期抗菌药物应用,而术后感染率和并发症均无明显增加,且医疗费用较低,具有较高的临床应用价值。OBJECTIVE To investigate the clinical significance of peritoneal lavage with traditional Chinese medicine （TCM） in elective laparoscopic cholecystectomy so as to alternate the antibiotics used during perioperative period. METHODS Totally 93 hospitalized patient with benign gallbladder lesions were randomly divided into three groups with 31 cases in each and underwent elective laparoscopic cholecystectomy under general anesthesia, then the three group were respectively treated with the TCM lavage （group A）, intravenous drip of antibiotics and saline lavage （group B）, or normal saline lavage alone （group C）, and the postoperative body temperature, incidence Of infec-tions, change of liver function, and medical cost of the three groups were observed and compared. RESULTS The incidence rate of postoperative infections was 9.7% in the group A, 6. 5% in the group B, significantly higher than that of the group C; the medical cost was （7.9±0.5） thousand yuan in the group A, （7.7±0.3） thousand yuan in the group C, significantly less than （9.1±0.5） thousand yuan of the group B, the difference was statisti- cally significant （P〈0. 05） % the postoperative adverse reactions have not occurred in the group A. CONCLUSION Peritoneal lavage with traditional Chinese medicine can be served as an alternative for the perioperative use of anti biotics, and the incidence of postoperative infections or complications does not increase significantly, the medical cost is relatively low, thus it is worthy to be promoted in the hosoital.

关 键 词：腹腔镜 中药 腹腔灌洗 抗菌药物 

分 类 号：R181.32[医药卫生—流行病学]