抗生素使用时间对肾移植围术期感染的影响  

Effect of utility duration of antibiotic on perioperative infection in renal transplant

作　　者：王伟[1] 张强[1] 范博涵 蒋一航 王玮[1] 尹航[1] 胡小鹏[1] 张小东[1] 

机构地区：[1]首都医科大学附属北京朝阳医院泌尿外科,100020

出　　处：《中国医药》2015年第11期1676-1678,共3页China Medicine

基　　金：北京市医院管理局重点医学专业发展计划（ZYLX201408）

摘　　要：目的 比较抗生素头孢西丁钠使用时间对肾移植围术期感染的影响.方法 选择2013年3-12月于首都医科大学附属北京朝阳医院接受首次尸体肾移植患者40例,将患者完全随机分为2组（各20例）,1周组给予头孢西丁钠2g/次,2次/d,共7d,2周组给予头孢西丁钠2g/次,2次/d,共14 d,2组患者均术前0.5～2.0 h静脉滴注头孢西丁钠2 g.比较2组患者一般资料、细菌感染情况和不良反应发生情况.结果 2组患者年龄、性别、透析类型、原发病、中心静脉导管保留时间、导尿管保留时间比较,差异均无统计学意义（均P ＞0.05）,1周组住院时间、住院费用明显低于2周组[（17±5）d比（22 ±8）d、（61 253±13 651）元比（70 382±11 527）元],差异有统计学意义（P＜0.05）.1周组发生感染3例（15.0％）,均为尿路感染;2周组发生感染4例（20.0％）,其中尿路感染2例,切口感染1例,肺部感染1例.2组移植后感染发生率差异无统计学意义（P＞0.05）.2组均无过敏反应发生,有3例患者出现腹泻,2例患者白细胞降低,调整药物剂量后症状消失.结论 肾移植患者围术期抗生素使用时间缩短,并不增加感染发生率,且可以缩短住院时间,降低住院费用。Objective To explore the effect of duration of sodium cefoxitin on perioperative infection in renal transplant.Methods Totally 40 patients undergoing renal allograft transplantation from March to December 2013 were randomly divided into 1-week group treated with sodium cefoxitin （2 g/time, 2 times/d） for 7 days and 2-week group treated with sodium cefoxitin （2 g/time, 2 times/d） for 14 days.All recipients were administrated with sodium cefoxitin （2 g） intravenously 0.5-2.0 h before surgery.The general clinical data, incidences of infection and adverse events were compared between groups.Results There were no statistical differences in age, sex, type of dialysis, primary disease, length of central venous catheter retention time and urinary catheter retention time between two groups （P 〉 0.05）.The hospitalization duration and hospitalization expenses in 1-week group were significantly shorter and lower than those in 2-week group [（17 ±5） d vs （22 ± 8） d, （61 253 ± 13 651） yuan vs （70 382 ± 11 527） yuan] （P 〈0.05）.The incidence of infection in 1-week group was 15.0% （3/20）, all being urinary tract infection;the incidence of infection in 2-week group was 20.0% （1/20）, being urinary tract infection in 2 cases, wound infection in 1 case and lung infection in 1 ease;no significantly difference was found between groups （P 〉 0.05）.No allergic reactions occurred in both groups;diarrhea occurred in 3 cases and leukopenia occurred in 2 cases, being disappeared after changing medicines.Conclusions Reducing utility duration of antibiotics after kidney transplantation does not increase the incidence of infection, and can shorten the hospitalization duration and reduce the costs.

关 键 词：肾移植 围术期 抗生素 感染 

分 类 号：R617[医药卫生—外科学]