Lee Tzong-Hsi, Huang Chung-Tsui, Lin Chien-Chu, Chung Chen-Shuan, Lin Cheng-Kuan, Tsai Kuang-Chau
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan; Department of Nursing, Oriental Institute of Technology, New Taipei, Taiwan.
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei, Taiwan.
J Formos Med Assoc. 2016 Jul;115(7):547-52. doi: 10.1016/j.jfma.2016.01.006. Epub 2016 Feb 15.
BACKGROUND/PURPOSE: Although prophylactic antibiotics have been recommended for cirrhotic patients with upper gastrointestinal bleeding, the duration of its use remains an inconclusive issue. We designed this study to investigate the duration of antibiotic prophylaxis for cirrhotic patients with acute esophageal variceal bleeding.
We enrolled those patients suffering from acute esophageal variceal bleeding and receiving band ligation. They were randomly allocated to two groups to receive prophylactic antibiotics; Group I: receiving intravenous ceftriaxone 500 mg every 12 hours for 3 days, and Group II: same regimen for 7 days. We used rebleeding rate within 14 days as the primary end point and also evaluated the survival rate within 28 days and the amount of transfusion during admission.
There were 38 patients in Group I and 33 patients in Group II that completed the study course for analysis. Overall, there was no significant difference in the baseline characteristics between these two groups. There were three patients both in Group I and Group II who developed rebleeding within 14 days (8% vs. 9%, p > 0.99). There was also no difference between Group I and Group II in transfusion amount (2.71 ± 2.84 units vs. 3.18 ± 4.07, p = 0.839) and survival rate in 28 days (100 vs. 97%, p = 0.465).
Our small scale study demonstrated that there was no difference in the rebleeding rate between 3-day and 7-day ceftriaxone prophylaxis for cirrhotic patients with acute esophageal variceal bleeding. There was also no difference in 28 day survival rate between these two groups.
背景/目的：尽管已推荐对肝硬化上消化道出血患者使用预防性抗生素，但其使用时长仍是一个尚无定论的问题。我们开展本研究以调查肝硬化急性食管静脉曲张出血患者预防性使用抗生素的时长。
我们纳入了那些患有急性食管静脉曲张出血且接受套扎术的患者。他们被随机分为两组接受预防性抗生素治疗；第一组：每12小时静脉注射头孢曲松500毫克，共3天，第二组：相同方案治疗7天。我们将14天内再出血率作为主要终点，同时评估28天内生存率及住院期间输血量。
第一组有38例患者、第二组有33例患者完成了研究疗程以供分析。总体而言，两组间基线特征无显著差异。第一组和第二组均有3例患者在14天内发生再出血（8%对9%，p>0.99）。第一组和第二组在输血量（2.71±2.84单位对3.18±4.07，p=0.839）和28天生存率（100%对97%，p=0.465）方面也无差异。
我们的小规模研究表明，对于肝硬化急性食管静脉曲张出血患者，3天和7天头孢曲松预防性治疗的再出血率无差异。两组间28天生存率也无差异。
