在接受复杂的干净污染头手术的患者中使用抗生素:一项前性研究
Pierre Mestrallet1, Antoine Yanni1, Alain Roman2
1Department of Stomatology-Maxillofacial Surgery, CHU Saint Pierre, Université Libre de Bruxelles (ULB), Brussels, Belgium.
Journal of International Society of Preventive & Community Dentistry
|October 25, 2023
概括
在头部和部癌症手术中长期使用术后抗生素并没有减少手术部位感染 (SSI). 在这项研究中,甲状腺功能低下病史是SSI的唯一显著预测因素. 结果可以为有关抗生素持续时间的临床决策提供信息.
科学领域:
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
- 外科手术的结果
背景情况:
- 上空消化道的瘤外科手术,包括部剖析和片重建,是复杂的.
- 手术部位感染 (SSIs) 是一个显著的并发症,导致结,延迟愈合,增加发病率/死亡率.
- 优化抗生素策略对于改善这些患者的术后结果至关重要.
研究的目的:
- 进行术后结果的系统描述性分析.
- 评估适应抗生素治疗方案策略对SSI和其他并发症的影响.
- 评估短期 (24小时) 与延长 (>24小时) 术后抗生素疗程的影响.
主要方法:
- 47名接受重大干净污染头手术 (2019-2022) 的患者的前性队列研究.
- 患者被分为两组:24小时抗生素治疗方案与>24小时治疗方案.
- 用于评估抗生素治疗方案对结果的预后意义的单变量分析,包括感染的临床迹象和生物标志物 (WBC,CRP).
主要成果:
- 18名患者 (38.3%) 患有2级SSI,所有患者都接受了抗生素治疗.
- 甲状腺功能低下史是SSI的唯一显著预测因素 (P=0.038).
- 在24小时和>24小时抗生素组之间,SSI发病或住院时间没有显著差异;多药耐药细菌的发病率也相似.
结论:
- 经过24小时以上的术后抗生素给药似乎不会在进行重大头瘤手术后为预防SSI带来额外的益处.
- 甲状腺功能低下症可能是这种患者群体中SSI的危险因素.
- 临床医生在做出关于抗生素持续时间的决定时应该考虑这些发现,特别是在没有具体指导方针的情况下.
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