术内细菌培养不能可靠地预测尾炎后感染并发症期间遇到的细菌谱
Jens K H Strohäker1, Martin J Brüschke2, Robert Bachmann2
1Department of General, Visceral and Transplantation Surgery, University Hospital of Tübingen, Hoppe-Seyler-Straße 3, 72076, Tübingen, Germany. Jens.Strohaeker@med.uni-tuebingen.de.
Updates in surgery
|December 7, 2023
概括
在尾切除术中,常规的微生物学测试对个体患者提供了有限的益处. 经验性抗生素和源控制是治疗尾炎的关键,无论培养结果如何.
科学领域:
- 手术急救医学手术急救医学
- 传染病管理 传染病管理
- 临床微生物学 临床微生物学
背景情况:
- 急性尾炎是经常发生的外科紧急情况,需要迅速干预.
- 术后抗生素是复杂尾炎的标准,以预防传染性并发症.
- 在尾切除术中常规微生物学测试的实用性受到争论.
研究的目的:
- 为了评估外科手术期间在尾切除术中使用抗生素.
- 确定手术内微生物检测作为传染性并发症预测的益处.
- 评估微生物学测试对患者结果的影响.
主要方法:
- 对1218名接受尾切除术的患者 (2014-2021) 的回顾性分析.
- 对患者病历进行系统审查,以查看手术内发现,微生物学结果和手术后感染并发症.
- 简单和复杂的尾炎病例之间的结果比较.
主要成果:
- 微生物学测试在复杂的尾炎 (74.9%) 中比不复杂的 (39.2%) 更频繁.
- 坏血性尾炎和穿孔性尾炎是手术部位感染 (SSI) 的强有力的预测因素.
- 从尾切除术和随后的SSI培养物中经常显示出不同的细菌; 98.3%的患者在经验性抗生素和源控制下具有良好的感染结果.
结论:
- 术内微生物学测试对导致尾炎的SSI的细菌具有较低的预测价值.
- 常规的微生物学测试为接受尾切除的个体患者提供了最小的直接益处.
- 有效的源控制和经验性抗生素治疗对于成功管理尾炎并发症至关重要.
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