甲硝唑联合头孢呋辛钠在腹腔镜治疗急性非单纯性阑尾炎患者中的应用效果

Effectiveness of metronidazole combined with cefuroxime sodium in the laparoscopic treatment of patients with acute non-simple appendicitis

摘要:

目的 探讨甲硝唑联合头孢呋辛钠在腹腔镜治疗急性非单纯性阑尾炎患者中的应用效果。方法 选取2020年7月－2023年6月于该院急诊外科行腹腔镜阑尾切除术的急性非单纯性阑尾炎患者80例。应用甲硝唑联合头孢呋辛钠的患者作为观察组（n = 41），应用甲硝唑联合头孢曲松钠的患者作为对照组（n = 39）。对比两组患者术中情况、手术前后炎症控制情况、术后恢复情况和用药后不良反应。结果 两组患者术中阑尾周围脓肿/腹膜炎、手术时间和术中出血量比较，差异均无统计学意义（P > 0.05）；两组患者手术后各炎症指标逐渐恢复至正常水平，观察组手术后第1和3天白细胞计数、降钙素原（PCT）和C反应蛋白（CRP）水平回落幅度明显大于对照组，差异均有统计学意义（P < 0.05）。观察组镇痛药物使用时间和住院时间分别为（1.8±1.2）和（3.5±0.7）d，明显短于对照组的（2.7±1.4）和（4.6±0.4）d，差异均有统计学意义（P < 0.05）。观察组腹部感染发生率为7.7%，明显低于对照组的24.4%，差异有统计学意义（P < 0.05）。两组患者用药后不良反应发生率分别为4.9%和7.7%，差异无统计学意义（P > 0.05）。结论 甲硝唑联合头孢呋辛钠应用于腹腔镜阑尾切除术中，可以明显降低急性非单纯性阑尾炎患者的腹部感染发生率，安全性高。

Abstract:

Objective To investigate the application value of metronidazole combined with cefuroxime sodium in the laparoscopic treatment of patients with acute non-simple appendicitis.Methods The subjects were 80 patients with acute non-simple appendicitis who underwent laparoscopic appendectomy from July 2020 to June 2023. Among them, 41 patients with acute non-simple appendicitis who were treated with metronidazole combined with cefuroxime sodium for laparoscopic surgery were used as the observation group, and 39 patients with acute non-simple appendicitis who were treated with metronidazole combined with ceftriaxone sodium for laparoscopic surgery were used as the control group. The intraoperative situation, inflammation control before and after surgery, postoperative recovery status, and adverse reactions after medication were compared between the two groups.Results There were no statistically significant difference between the two groups in terms of periappendiceal abscess/peritonitis, surgical time, and intraoperative bleeding, the differences were not statistically significant (P > 0.05); The inflammatory indexes of acute non-simple appendicitis in both groups gradually returned to normal after surgery, and the white blood cell count, procalcitonin (PCT) and C-reaction protein (CRP) levels in the observation group showed greater decrease than those in the control group, the differences were statistically significant (P < 0.05) on the first day and the third day after surgery. The duration of analgesics use and hospital stay in the observation group were (1.8 ± 1.2) and (3.5 ± 0.7) d, respectively, which were significantly shorter than those of (2.7 ± 1.4) and (4.6 ± 0.4) d, the differences were statistically significant (P < 0.05). The incidence of intra-abdominal infection in the observation group was 7.7%, which was significantly lower than that of 24.4% in the control group, the difference was statistically significant (P < 0.05). The adverse reactions in the two groups were 4.9% and 7.7%, respectively, and the difference was not significant (P > 0.05).Conclusion Metronidazole combined with cefuroxime sodium combined with laparoscopic appendectomy can significantly reduce the incidence of abdominal infection in patients with acute non-simple appendicitis, it has high safety.