经验性抗生素治疗对急性结石性胆囊炎患者预后的影响  

The impact of empirical antibiotic treatment on the prognosis of patients with acute calculous cholecystitis

作　　者：寇伟伟 惠朝阳 任广明 党张峰 Wei-Wei KOU;Chao-Yang HUI;Guang-Ming REN;Zhang-Feng DANG(Department of General Surgery,The 986th Hospital of Chinese People's Liberation Army Air Force,Xi'an 710062,China)

机构地区：[1]中国人民解放军空军第九八六医院普通外科,西安710062

出　　处：《中国药师》2023年第11期293-297,共5页China Pharmacist

摘　　要：目的 探究经验性抗生素治疗(EAT)对急性结石性胆囊炎(ACC)患者并发症和死亡的影响。方法 回顾性收集2016年1月至2022年1月中国人民解放军空军第九八六医院普外科就诊的ACC患者病历资料。根据抗生素的使用情况,将ACC患者分为充分EAT(AEAT)组和不充分EAT(IEAT)组。观察并分析两组ACC患者并发症发生率和30 d住院死亡率。结果 研究共纳入504例ACC患者,337例(66.87%)ACC患者被纳入AEAT组,167例(33.13%)ACC患者被纳入IEAT组。多因素Logistic回归分析显示,AEAT是总并发症[OR=0.625,95%CI(0.419,0.932),P=0.021]和感染并发症[OR=0.512,95%CI(0.33,0.791),P=0.003]的保护因素。多因素COX风险比例回归分析显示,AEAT是ACC患者30 d死亡风险的保护因素[HR=0.238,95%CI(0.070,0.810),P=0.022]。结论AEAT可降低ACC患者并发症发生率和死亡率。Objective To explore the impact of empirical antibiotic treatment(EAT) on complications and mortality in patients with acute calculous cholecystitis(ACC).Methods This study retrospectively collected ACC patients from the department of general surgery of The 986th Hospital of Chinese People's Liberation Army Air Force from January 2016 to January 2022.According to the use of antibiotics,ACC patients were divided into an adequate EAT(AEAT) group and an insufficient EAT(IEAT) group.The incidence of complications and 30-day hospitalization mortality rate in two groups of ACC patients were observed and analyzied.Results A total of 504 ACC patients were included in this study.337(66.87%) ACC patients were included in the AEAT group,and 167(33.13%)ACC patients were included in the IEAT group.Multivariate Logistic regression analysis showed that AEAT was a protective factor for total complications [OR=0.625,95%CI(0.419,0.932),P=0.021] and infection complications [OR=0.512,95%CI(0.331,0.791),P=0.003].Multivariate COX risk proportional regression showed that AEAT was a protective factor for the 30-day mortality risk in ACC patients [OR=0.238,95%CI(0.070,0.810),P=0.022].Conclusion AEAT can reduce the incidence of complications and mortality in ACC patients.

关 键 词：胆囊炎 急性结石性胆囊炎 经验抗生素治疗 并发症 

分 类 号：R575.61[医药卫生—消化系统]