Bezrodnyĭ B H, Kolosovych I V, Iovitsa A V, Martynovych L D, Sydorenko R A, Sysak O M
Lik Sprava. 2012 Apr-Jun(3-4):90-6.
Character of microflora of exsudate of abdominals and mucosis microflora of vermicular appendix is studied for patients with the destructive forms of appendicitis with the purpose of development of variants of antibacterial therapy at surgical treatment of patients with acute appendicitis. The patients with the destructive forms of appendicitis, which were on treatment in a municipal clinical hospital N 4 Kyiv for period 2004-2010. An Inflammatory-destructive process in an appendix is conditioned by both aerobic (Escherichia coli - 46,6 %, Enterobacter - 4,2 %, Citrobacter - 4,2 %, Klebsiella - 3,3 %, Pseudomonas aeruginosa - 5,8 %, Staphylococcus - 4,2 %) and anaerobic microorganisms (Bacteroides - 100 %) and increase Candida - 17,5 %. Antibacterial therapy is effective at 46,7 % patients with acute appendicitis. At 49,6 % patients acute appendicitis develops on a background dysbiotic intestinal disturbances. Clinically the effective charts of empiric antibacterial monotherapy 6 days it is been: Moxifloxacini intravenously 400 mgs one time in twenty-four hours during, Ertapenemi for a 1 g one time in twenty-four hours intravenously and combined - Aztreonami for a 1 g twice in twenty-four hours and of Clindamycini for 600 mgs twice in twenty-four hours, intramuscular during; Cefepimumi for a 1 g twice in twenty-four hours and of Clindamycini for 600 mgs twice in twenty-four hours, intramuscular.
为了制定急性阑尾炎患者手术治疗时的抗菌治疗方案,对患有坏疽性阑尾炎的患者的腹部渗出物微生物群落特征和阑尾黏液病微生物群落进行了研究。研究对象为2004年至2010年期间在基辅市第4市立临床医院接受治疗的坏疽性阑尾炎患者。阑尾的炎症性破坏过程由需氧菌(大肠杆菌 - 46.6%,肠杆菌 - 4.2%,柠檬酸杆菌 - 4.2%,克雷伯菌 - 3.3%,铜绿假单胞菌 - 5.8%,葡萄球菌 - 4.2%)和厌氧菌(拟杆菌 - 100%)以及念珠菌增加(占17.5%)引起。抗菌治疗对46.7%的急性阑尾炎患者有效。49.6%的急性阑尾炎患者在肠道生态失调的背景下发病。临床上经验性抗菌单药治疗6天的有效方案为:静脉注射莫西沙星400毫克,每24小时1次;静脉注射厄他培南1克,每24小时1次;联合用药——静脉注射氨曲南1克,每24小时2次,克林霉素600毫克,每24小时2次,肌肉注射;头孢吡肟1克,每24小时2次,克林霉素600毫克,每24小时2次,肌肉注射。