肝硬化食管胃底静脉曲张破裂出血患者预防性应用抗生素的疗效分析

Efficacy of prophylactic antibiotics in cirrhosis patients with gastroesophageal variceal bleeding

摘要:

目的探讨早期预防性应用抗生素对肝硬化食管胃底静脉曲张破裂出血患者的疗效。方法将120例肝硬化食管胃底静脉曲张破裂出血患者随机分为抗生素预防性治疗组（60 例）和对照组（60 例），两组患者均常规给予制酸、止血、降低门静脉压力及输血等治疗。治疗组患者入院后同时给予头孢噻肟钠2.0 g静脉滴注，2次/d，疗程7 d，对照组未应用抗生素，比较两组患者再出血率、死亡率以及医院感染率间的差异。结果治疗组再出血率、死亡率及医院感染率分别为8.90%、5.4%及17.9%；对照组分别为23.1%、17.3%及53.8%，两组比较差异有统计学意义（P <0.05）。结论对肝硬化食管胃底静脉曲张破裂出血患者早期预防性应用抗生素，可降低其再出血率、死亡率及医院感染率，提高患者的生活质量。

Abstract:

Objective To explore the effect of early prophylactic antibiotics in cirrhosis patients with gastroesophageal variceal bleeding. Methods A total of 120 cirrhosis patients with gastroesophageal variceal bleeding were randomly assigned to antibiotic prophylaxis group (n = 60) and control group ( n= 60), and all of them were provided with routine treatment including inhibition of acid, hemostasis, reduction of portal pressure and blood transfusion. Patients were received intravenous infusion of Cefotaxime Sodium (2.0 g, Bid, 7 days) in the antibiotic prophylaxis group. The incidence of re -bleeding, mortality and nosocomial infections were analysed between the two groups. Results There were statistical differences (P < 0.05) between the antibiotic prophylaxis group and the control group in the incidence of rebleeding (8.90% / 23.1%), mortality (5.4% /17.3%) and the incidence of nosocomial infections (17.9% / 53.8%). Conclusions Prophylactic antibiotics can decrease incidence of re-bleeding, mortality and nosocomial infections of cirrhosis patients with gastroesophageal variceal bleeding to improve their quality of life.