中西医结合治疗重症急性胰腺炎不预防性使用抗生素的临床研究3300.doc

中西医结合治疗重症急性胰腺炎不预防性使用抗生素的临床研究 Clinical Study of patients with severe acute pancreatitis with integrated traditional Chinese and Western medicine therapy under non-preventive use of antibiotics [摘要] 目的:探讨接受中西医结合治疗重症急性胰腺炎患者，不预防性使用抗生素后的影响。方法:在我院收治的重症急性胰腺炎患者中，随机抽取60例确诊患者分成试验组和对照组，两组在接受益活清下为主的中西医治疗方案时，试验组接收预防性抗生素的治疗，对照组不接收预防性抗生素的治疗。观察两组并发症发生率、中转手术率、住院率和死亡率。结果:两组患者在病程，性别和年龄等基本方面无显著统计学差异，通过治疗和观察得出两组并发症发生率、中转手术率、住院率和死亡及率没有明显差异,不存在统计学意义。结论: 在重症急性胰腺炎治疗中结合应用中医疗法，能够避免抗生素的使用，同时并发影响继发感染的发生率。 【关键词】中西医结合; 重症急性胰腺炎;抗生素;感染 Objective:To study the prognostic effects on patients with severe acute pancreatitis(SAP), who accept the integrated traditional Chinese and Western medicine therapy but without antibiotics in treatment. Methods: Divide the 60 SAP patients randomly into experimental group(30cases included)and control group (30cases included). While accept the same treatment, experimental group use the antibiotics preventively in addition. Observe the difference of complications incidence, operating conversive rate, hospitalization rate and mortality between the two groups. Results: There were no statistical differences in the course of disease, sex, age and other basic date among these 60patients. The complications incidence, operating conversive rate, hospitalization rate and mortality incidence rates did no have statistical differences neither. Conclusion: The study cannot confirm that the incidence rates of secondary infection and mortality reduced by the preventive use of antibiotics. Keywords: integrated traditional Chinese and Western medicine therapy; severe acute pancreatitis; antibiotics; infection 近年来，随着科技和医疗科学卫生事业的发展，急性胰腺炎的发病率和死亡率得到了有效控制。我们采用中西医结合的方法治疗SAP取得了显著的疗效[1]，这一结合方案使胰腺脓肿、感染性胰腺坏死等感染并发症明显减少,因而中转手术者明显减少,病死率明显下降[2]。临床上现今普遍采用预防性抗生素,以期降低胰腺及胰周的感染，但是不合理的应用抗菌素的后果,可能会导致二重感染，增加治疗难度。本研究旨在通过临床随机对照试验，研究以活血化瘀、益气救阴、通里攻下和活血化瘀为基础的中西医结合疗法治疗SAP的过程中不预防性使用抗生素对患者继发感染和病死率的影响。 1 资料与方法 1.1 一般资料 随机抽取我院收治的60名急性胰腺炎患者，试验组和对照组各30名。其中试验组男性患者12名，女性患者18名，对照组男性患者14名，女性患者16名。患者平均年龄42.3岁，病程平均4.2年。两组患