肝门部胆管癌ERCP前应用抗菌药物能否降低术后胆管炎发生率——附138例对照研究

Whether preERCP antimicrobial use can decrease postERCP cholangitis rate in patients with hilar cholangiocarcinoma:a casecontrol study of 138 cases

摘要:

目的验证逆行胰胆管造影（ERCP）前应用抗菌药物能否降低术后胆管炎发生率。方法选择肝门部胆管癌需行ERCP治疗的患者138例，随机分为试验组（67例）与对照组（71例）。试验组于ERCP治疗前30 min静脉注射头孢哌酮1.0 g；对照组按常规操作，不应用抗菌药物。结果两组患者一般临床资料比较，差异无统计学意义（P＞0.05），具有可比性。ERCP术后，试验组胆管炎发生率为34.33%（23/67），对照组为26.76%（19/71），两组胆管炎发生率差异无统计学意义（χ2=0.360，P=0.152）。结论对高感染率的病种行ERCP治疗，仅通过术前单剂量应用抗菌药物来降低ERCP治疗后胆管炎发生率，效果不甚理想。

关键词:

肝门部胆管癌;逆行胰胆管造影;胆管炎;抗菌药物;预防用药;合理用药

Abstract:

ObjectiveTo investigate whether antimicrobial use before endoscopic retrograde cholangiopancreatography (ERCP) can decrease postERCP cholangitis rate.Methods138 patients with hilar cholangiocarcinoma were randomly grouped into experimental group (67 cases) and control group(71 cases). Patients in experimental group accepted intravenous injection of cefoperazone sodium 1.0 g 30 min before ERCP, control group were treated routinely and without using antimicrobial agents.ResultsThere was no significant difference in general clinical data between two groups(P>0.05). After receiving ERCP, cholangitis rate in experimental group and contro group was 34.33%（23/67） and 26.76%（19/71）respectively, there was no significant difference between two groups (χ2=0.360, P=0.152).ConclusionPreERCP antimicrobial use is not ideal for decreasing postERCP cholangitis rate.

Key words:

hilar cholangiocarcinoma; endoscopic retrograde cholangiopancreatography; cholangitis; antimicrobial agents;preventive drug use; rational use of drug