吗啉硝唑联合腹腔镜微创手术治疗急性非单纯性阑尾炎有效性及安全性分析  

The effectiveness and safety of Morinidazole for acute complicated appendicitis undergoing laparoscopic appendectomy

作　　者：陈志达[1] 郗洪庆[1] 唐云[1] Chen Zhida;Xi Hongqing;Tang Yun(Department of General Surgery,First Medical Center of Chinese PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心普通外科医学部,北京100853

出　　处：《中华普通外科杂志》2022年第1期35-38,共4页Chinese Journal of General Surgery

摘　　要：目的探讨吗啉硝唑联合腹腔镜微创手术治疗急性非单纯性阑尾炎的有效性和安全性。方法回顾性分析解放军总医院第一医学中心普通外科2017年1月至2019年6月收治的急性阑尾炎患者病例资料,共计387例。应用吗啉硝唑+依替米星二联抗生素联合腹腔镜微创手术治疗的54例患者设为实验组。按照倾向评分匹配,另外54例使用奥硝唑+左氧氟沙星二联抗生素腹腔镜微创手术治疗的患者设为对照组。对比分析两组患者术后恢复情况。结果经过1∶1倾向性得分匹配后,实验组和对照组具有可比性。实验组的术前、术后第1天、术后第3天的白细胞计数、C反应蛋白和降钙素原三种炎症指标变化程度均高于对照组(均P<0.05)。实验组的住院时间和镇痛药物使用时间短于对照组(均P<0.05)。结论吗啉硝唑联合腹腔镜微创手术能够有效控制急性非单纯性阑尾炎造成的腹腔感染,体现了较好的有效性和安全性。Objective To analyze the effectiveness and safety of Morinidazole combined laparoscopic appendectomy for acute purulent appendicitis and acute gangrene appendicitis.Methods We retrospectively retrieved 387 acute appendicitis patients who have received surgery or conservative treatment from Jan 2017 to Jun 2019.Firty four patients with Morinidazole+Etimicin bigeminy combined laparoscopic surgery were set to experimental group.The other 54 cases using ornidazole+levofloxacin bigeminy combined laparoscopic appendectomy were enrolled into control group after Propensity Score Matching.Results After 1∶1 propensity score matching,there was no statistically significant difference between the two groups and control group in clinical features.The white blood cell count,C-reactive protein and calcitonin original inflammation index change were higher in experimental group than in the control group,both preoperatived and on post-op day1 and day 3(all P<0.05).In the experimental group the length of hospital stay and analgesic drug usetime were shorter than in the control group(all P<0.05).Conclusion Morinidazole combined laparoscopic appendectomy can effectively control the intra-abdominal infection caused by acute purulent appendicitis and acute gangrene appendicitis with less adverse reactions.

关 键 词：阑尾炎 外科手术 微创性 吗啉硝唑 急性厌氧菌感染 

分 类 号：R656.8[医药卫生—外科学]