胰腺切除术后长期抗生素预防:系统性审查和元分析
Daphne H M Droogh1, Jesse V Groen1, Mark G J de Boer2
1Department of Surgery, Leiden University Medical Centre, Leiden, the Netherlands.
The British journal of surgery
|July 13, 2023
概括
长时间的抗生素预防可能会减少胰腺切除术后的器官/空间感染,特别是在手术前胆道排水的患者中. 需要进一步的研究来确定最佳的抗生素持续时间.
科学领域:
- 手术瘤学手术瘤学
- 传染病 传染病 传染病 传染病
- 胃肠病学 胃肠病学
背景情况:
- 关于长时间的抗生素预防和胰腺切除术后的传染性并发症,存在相互矛盾的证据.
- 手术部位感染 (SSIs) 是胰腺除术后的一个重大问题.
研究的目的:
- 评估长期抗生素预防在胰腺切除术后对SSI的影响.
- 为了比较术后与长期抗生素策略在预防SSI.
主要方法:
- 对比术后 (<24小时) 和长期 (>24小时) 抗生素预防的研究的系统审查和元分析.
- 在30天内被归类为器官/空间或表面感染的SSI.
- 分析使用了曼特尔-汉泽尔固定效应模型.
主要成果:
- 长期预防没有显示出整体器官/空间SSI (OR 1.35) 的显著差异.
- 然而,长期预防与手术前胆汁排水 (OR 2.09) 患者的下部器官/空间SSI有关.
- 在手术前胆道排水或不排水的情况下,表面SSI的发病率在各组之间是可比的.
结论:
- 长时间的抗生素预防可以通过减少器官/空间感染,有利于接受手术前胆道排水的患者.
- 胰腺切除术后抗生素预防的最佳持续时间需要进一步调查.
- 随机对照试验是有必要的,以证实这些发现.
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