Study On The Ultrasound-mediated Targeted Drug Delivery Technology Used In Anti-infection Of Anorectal Diseases Post-operative Incision

Objective:To evaluate the anti-infection effect of the ultrasound-mediated targeted drug delivery technology on the post-operative incision of common anorectal diseases,providing valid and reliable clinical evidence for the adjunctive therapy after anorectal operations.Methods:In this clinical trial,adhering to the selection criteria,600 operation cases with mixed hemorrhoids,anal fissure,anal fistula or perianal abscess were selected from January 2015 to January 2017 in the department of traditional Chinese medicine of the first affiliated hospital of Nanchang University.This trial allocated all cases randomly into two groups,utilising a table of random numbers,the treatment group with the ultrasound-mediated targeted drug delivery technology and on the control group with the traditional drug delivery method.Both of the groups were applied cefoxitin with different drug delivery methods,from the first day of post-operation to the fifth day,30 minutes per day.Routine nursing and post-operative incision disinfection were also used in both groups.Results:Compared to the control group,the incision healing rate and the total effective rate were significantly increased in the treatment group on the sixth day of post-operation(P<0.05).During the perioperative period,distinct fluctuation of serum C-reactiveprotein(CRP),serum procalcitonin(PCT)and serum erythrocyte sedimentation rate(ESR)were found in both of the groups(P<0.05).On the sixth day of post-operation,the serum CRP,serum PCT and serum ESR were significantly decreased in the treatment group,compared to the control group(P<0.05).However,the serum levels of CRP,PCT and ESR in these two groups are similar on the first day of post-operation.Additionally,the hospital day,total inpatient costs and patient satisfaction were distinctly better than the control group(P<0.05).On the sixth day of post-operation,the reduction rate in the postoperative incision area was significantlyhigher than the control group(P<0.05).In contrast,the incision healing time,postoperative activity out of bed days and time of epithelium covering incision were lower in the treatment group(P<0.05).The incidence rate of adverse response on the sixth day of post-operation was distinctly decreased,compared to the control group(P<0.05).Furthermore,the symptoms of anal pain,incision swelling and infiltration degree were significantly better than the control group on the sixth day(P<0.05).Moreover,for operative complications,the treatment group obviously relieved anal swelling and incision pain,compared to the control(P<0.05),although there is no statistical significance for the complications of incision bleeding and retention of urine between these two groups.Finally,in the granulation tissue,positive expressions of cluster of differentiation 68(CD68),lysozyme(Lyn),vascular endothelial growth factor(VEGF)and fibroblast growth factor(SMA)were noticed in both of the groups.The expressions of CD68,VEGF and SMA were significantly increased in the treatment group,compared to the control one.However,the expression of Lyn was similar in both groups.Conclusions:As an innovative and antibiotic delivery technology,the ultrasound-mediated targeted drug delivery technology can better tackle a sequence of clinical issues with appropriate time and space management.Compared to the traditional drug delivery method,the ultrasound-mediated targeted drug delivery technology achieved much better clinical outcomes and higher grades of clinical efficacy evaluation.Specifically,it can reduce the incidence of incision infection,shorten the inflammatory phase after anorectal operations,relieve the local inflammatory response and stimulate the incision healing.Additionally,it can prolong the action of antibiotics,improve the transdermal absorption and reduce the side effects of cefoxitin,which means it can decrease drug dosage and enhance drug safety.Furthermore,it has higher incision healing rate,higher total effective rate and lower incisional infection rate,which means it can shorten hospital day,lower total inpatient costs and increase patient satisfaction.As a consequence,the ultrasound-mediated targeted drug delivery technology is a creative intervention with anti-infection effect for the post-operative patients with anorectal diseases.Widely used as a routine therapy after anorectaloperations can be considered during clinical practice.However,further clinical evidence is still needed to assess its safety and effects.