ABSTRACT
Objective To investigate the clinical value of splenic autotransplantation in patients with severe splenic trauma. Methods A prospective case-control study were performed in 120 patients with traumatic spleen rupture including the treatment group 72 patients and the control group 48 patients. The treatment group were treated with splenectomy plus spleen autotransplantation and the control group merely under splenectomy. Compare the operation time,operative blood loss,postoperative hospital stay,postoperative complications and the immune indexes before and different period after operation. Results Autologous spleen transplantation takes more time than merely splenectomy(P<0.05),but the operative blood loss,postoperative hospital stay and postopera-tive complications were no significant difference. 1 days after operation,the immune indexes of two groups were significantly lower than those before operation(P < 0.05),and 1 week after operation the immune indexes of two groups were significantly elevated(P<0.05).The immune indexes of the treatment group were better than those of the control group 3 months after operation(P < 0.05),and there was no significant difference compared with preoperative. Conclusion Splenectomy cause the decrease in the immune function,but the immune function can quickly rise to a certain level in short term.The splenic autotransplantation can effectively restore the immune func-tion to the preoperative level.
ABSTRACT
Objective To observe the effect of nystatin via gastrointestinal tract on the incidence of invasive fungal infections (IFI) and the prognosis of patients with mechanical ventilation in ICU.Methods A total of 118 critical ill patients admitted to ICU needing mechanical ventilation were enrolled.The patients were divided into two groups by random digits table method.Patients in study group (57 cases) were administered nystatin 1 000 kU three times a day via the gastric tube;and patients in control group (61cases) were given gastrointestinal prokinetic drug as placebo three times a day.The specimens were collected on admission,the third,the sixth,the ninth day after admission,the strain distribution was observed,and the corrected colonization index (CCI) of all patients were calculated.The incidence of candidemia and 28-day mortality as well as the duration of stay in ICU and hospital was also recorded.Results A total of 860 strains were isolated from 118 patients.Of which Candida albicans accounted for 56.9％ (489/860).The most frequently colonized body sites was oropharyngeal site [35.9％(309/860)].CCI on the sixth,the ninth day after admission in study group was lower than that in control group (0.18 ±0.09 vs.0.40 ±0.16 and 0.10 ± 0.02 vs.0.45 ± 0.13),28-day mortality in study group was lower than that in control group [17.5％(10/57) vs.34.4％(21/61)],the duration of stay in ICU in study group was shorter than that in control group [(9.45 ± 3.36) d vs.(11.78 ± 6.21) d],and there were significant differences (P ＜ 0.05).There were no significant differences in the incidence of candidemia and the duration of stay in hospital (P ＞0.05).Conclusion Nystatin may reduce the colonization of Candida albicans and is associated with shorter ICU day.