盆腔脓肿患者腹腔镜手术抗感染治疗的探讨  

Laparoscopic surgery after anti-infective therapy in patients with pelvic abscess

作　　者：钱红燕 沈伟 

机构地区：[1]杭州市萧山区萧山医院妇科,浙江杭州311200

出　　处：《中华医院感染学杂志》2014年第3期720-722,共3页Chinese Journal of Nosocomiology

基　　金：吴阶平医学基金临床科研专项基金资助项目(320675010111)

摘　　要：目的探讨盆腔脓肿患者应用抗菌药物抗感染治疗后选择腹腔镜手术治疗的最佳时间,并为该病的临床治疗提供最优方案参考。方法选取2010年4月-2012年9月妇科收治的88例盆腔脓肿患者,根据抗菌药物治疗时间长短进行分组,其中对照组43例患者为抗菌药物治疗7d后实施腹腔镜手术,研究组45例患者为抗菌药物治疗3d后实施腹腔镜手术,采用SPSS19.0软件进行数据统计分析。结果研究组术中出血量、手术时间、住院时间分别为(38.3±8.1)ml、(43.2±4.6)min、(5.0±1.1)d,对照组分别为(107.4±7.7)ml、(67.1±7.2)min、(12.4±3.8)d,差异均有统计学意义(P<0.05);研究组输卵管复通率和盆腔炎复发率分别为75.0%和6.7%,对照组分别为31.3%和41.9%,差异均有统计学意义(P<0.05)。结论盆腔脓肿患者应用抗菌药物抗感染治疗后3d采取腹腔镜手术,是一项科学、合理、有效的治疗手段,值得在临床上进一步推广。OBJECTIVE To explore the optimal time for laparoscopic surgery after anti-infective therapy in patients with pelvic abscess, and to provide the reference of optimal solution to the clinical treatment of the disease. METHODS A total of 88 cases of pelvic abscess patients admitted by our hospital from Apr. 2010 to Sep. 2012 were selected and divided into control group and observation group according to the length of antimicrobial treatment. A total of 43 cases of patients in observation group were given antimierobial treatment for 7 d followed by laparoscopic operation. While 45 cases of patients in control group were given antimicrohial treatment for 3 d followed by laparoscopie operation, the staristical analysis of data was performed with the use of SPSS19. 0 software. RESULTS The amount of bleeding during operation, operation time and hospitalization time in observation group were （38.3±8.1）ml, （43.2±4.6）min, （5.0±1. 1）d, respectively and in control group were （107.4±7.7）ml, （67.1±7.2）min, （12.4±3.8）d, respectively, and the differences were significant in both groups（P〈0.05）. The recanalization rate of fallopian tube and the recurrence rates of pelvic inflammatory disease in observation group were 75% and 6.7%, which in control group were 31.3% and 41.9%, and the differences were significant in both groups （P〈0.05）. CONCLUSION Laparoscopic surgery should he taken 3 d later of anti- infective fherapy to patients with pelvic abscess, which is a scientific, reasonable and effective treatment and worth popularizing in clinic.

关 键 词：盆腔脓肿 抗菌药物 抗感染 腹腔镜 最佳时机 

分 类 号：R181.32[医药卫生—流行病学]