@article{oai:kanazawa-u.repo.nii.ac.jp:00013157,
 author = {小田, 誠 and 石川, 紀彦 and 菊地, 勤 and 渡辺, 俊一 and 関戸, 伸明 and 太田, 安彦 and 村上, 眞也 and 渡辺, 洋宇},
 issue = {1},
 journal = {日本呼吸器外科学会雑誌},
 month = {Jan},
 note = {肺悪性腫瘍患者手術における2日間の予防的抗菌薬投与法の有効性を検討した.対象は肺悪性腫瘍手術例連続61例で, これを年代順に前半の31例(1群)と後半の30例(2群)に分けて比較検討した.抗菌薬は第2世代セフェムのflomoxefを1回1g, 1群では3日間, 2群では2日間点滴静注した.投与時期は1回目は麻酔導入時, 2回目は手術終了時としそれ以降は8時間毎に投与した.各群ともに1例で抗菌薬の変更, 投与期間の延長を要したが, 他の全例で予定期間の抗菌薬投与が行われた.創部感染は各群ともに1例づつ認めた.38℃以上の熱発日数は両群ともに1日未満であり, 術後膿胸, 手術死亡, 在院死は両群ともに認めなかった.平均白血球数, 平均CRP値ともに術前, 術後7日目および14日目において両群間で有意差を認めなかった.以上より肺悪性腫瘍手術において第2世代セフェムの2日間の予防投与は創部および深部感染予防に有効であると考えられた. The aim of this study was to determine whether a 2-day antibiotic prophylaxis regimen with a second-generation cephalosporin was effective in pulmonary operations for malignancies. We enrolled 61 consecutive patients who underwent elective thoracic surgery for lung cancer(n=55) or metastatic lung tumors(n=6). All the patients were given flomoxef(1.0 gm intravenously) at the time of anesthetic induction. Patients in group 1(n=31) were given flomoxef intravenously every 8 hounrs for a total of 8 times for 3 days immediately after ICU arrival. Patients in group 2(n=30) were given flomoxef intravenously every 8 hours for a total of 5 times for 2 days immediately after ICU arrival. Thirteen of 31 patients received 3-day antibiotic prophylaxis in group 1 and 29 of 30 patients received 2-day antibiotic prophylaxis in group 2. Antibiotics were altered in 1 patient in each group and the duration of antibiotic administration became longer than the planned duration in the same patients. No significant difference was seen in duration of fever more than 38℃ after surgery between the two groups. Wound infection was seen in 1 patient in each group. Empyema, death within 30 days after operation, and hospital death were not seen in either group. On day 7 and day 14 after operation, white blood cell counts and plasma CRP levels showed no significant differences between the two groups. These results suggest that 2-day antibiotic prophylaxis with a second-generation cephalosporin is of benefit for wound and other infections in pulmonary operations for malignancies., 金沢大学大学院医学系研究科血管病態制御学},
 pages = {22--26},
 title = {肺悪性腫瘍周術期の予防的抗菌薬投与法の検討},
 volume = {13},
 year = {1990}
}