五水头孢唑啉钠治疗腹膜透析腹腔感染的疗效及安全性  

The safety and efficacy of cefazolin sodium pent hydrate in treatment of peritoneal dialysis related peritonitis

作　　者：陈文超[1] 张琳[2] 韩斌[1] 高飞[1] 申腾飞[1] 郭云凯 

机构地区：[1]郑州大学第二附属医院普外科,450014 [2]河南省人民医院麻醉科

出　　处：《疑难病杂志》2017年第10期1030-1033,共4页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察五水头孢唑啉钠治疗腹膜透析腹腔感染的疗效和安全性。方法选择2013年3月—2016年3月郑州大学第二附属医院普外科诊治腹膜透析腹腔感染患者54例作为研究对象,按随机数字表法分成观察组和对照组各27例,观察组用五水头孢唑啉钠2 g加入1.5%腹透液8~12 L中持续透析9~10 h,并留存2 000 ml于腹腔(腹腔内保留时间为6~10 h),并加入肝素钠注射液8 mg,疗程为2周。对照组选用头孢唑啉注射液,用法、用量及疗程与五水头孢唑啉钠相同。比较2组总有效率,腹透液细菌清除率,透析相关指标血清白蛋白(Alb)、总肌酐清除率(CCr)、总尿素清除指数(KT/V)等,以及2组的不良反应发生率。结果观察组总有效率为81.5%,高于对照组的40.7%(χ~2=2.256,P=0.025)。观察组腹透液细菌清除率为91.7%,高于对照组的69.6%(χ~2=4.905,P<0.05)。观察组和对照组治疗前后Alb水平无显著变化(P>0.05),2组CCr、KT/V均较治疗前显著升高(CCr:t_(对照组)=1.995,P=0.043,t_(观察组)=2.656,P=0.011;KT/V:t_(对照组)=3.177,P<0.01,t_(观察组)=2.471,P<0.01),观察组升高尤为明显(t=2.453,P=0.027;t=2.164,P=0.043)。观察组的不良反应发生率为14.8%,低于治疗组的44.5%(χ~2=5.681,P<0.05)。结论五水头孢唑啉治疗腹膜透腹腔感染有效,不良反应发生率低,值得临床推广使用。Objective To observe the efficacy and safety of cefazolin sodium pent hydrate in the treatment of peritoneal dialysis.Methods Fifty-four cases of peritoneal dialysis related peritonitis were divided into observation group and control group,with 27 cases in each group.The observation group was treated with 2g of cefazolin sodium pent hydrate with 2000ml peritoneal dialysis solution keeping in abdominal for 6-10 hours once a day for 14 days.The control group was treated with cefazolin sodium and the dosage and treatment course was the same with the observation group.After the treatment,the total effective rate,bacteria clearance arte,serum album （Alb） and the dialysis related indexes such as the weekly creatinine clearance rate （CCr） and the weekly urea clearance index （KT/V） of the two groups were compared.Results The total efficiency of the observation group was 81.5%,higher than 40.7% in the control group （χ^2=2.256,P=0.025）.Observation of peritoneal fluid bacterial clearance group was 91.7%,higher than 69.6% in the control group （χ^2=4.905,P〈0.05）.The Alb level of the observation group and the control group before and after treatment no significant change （P〉0.05）,2 groups of Ccr and KT/V were significantly higher than those before treatment （Ccr：tcontrol group=1.995,P〈0.05,tobservation group=2.656,P〈0.05;KT/V：tontrol group=3.177,P〈0.01,tobservation group=2.471,P〈0.01）,the observation group was obviously increased （t=2.453,P〈0.05;t=2.164,P〈0.05）.Incidence of adverse reactions in observation group was 14.8%,lower than the treatment group＇s 44.5% （χ^2=5.681,P〈0.05）.Conclusion Cefazolin sodium pent hydrate in the treatment of peritoneal infection in patients with peritoneal infection is effective,the incidence of adverse reactions is low,it is worth to be popularized in clinical use.

关 键 词：五水头孢唑啉钠 腹膜透析 腹腔感染 疗效观察 

分 类 号：R459.5[医药卫生—治疗学]