使用安皮西林-苏尔巴克坦的抗菌预防与食道切除术中使用塞法林相比:日本全国性住院患者数据库研究
Yuki Hirano1, Takaaki Konishi2, Hidehiro Kaneko3
1Department of Hepatobiliary-Pancreatic and Gastrointestinal Surgery, International University of Health and Welfare School of Medicine, Chiba, Japan.
Annals of surgery
|December 15, 2023
概括
与塞法林 (CEZ) 相比,安皮西林-苏尔巴克坦 (ABPC/SBT) 显著减少了手术部位感染,肠道泄漏和食管切除后的呼吸衰竭. 这种抗微生物预防为接受这种重大手术的患者提供了更好的短期结果.
科学领域:
- 手术瘤学手术瘤学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 塞法索林 (CEZ) 是食道切除术的标准抗菌预防药物,但缺乏特定程序的证据.
- 氨基-硫巴克坦 (ABPC/SBT) 在一些中心用于更广泛地对抗口腔有氧和无氧细菌.
研究的目的:
- 为了比较安培-苏尔巴克坦 (ABPC/SBT) 与塞法林 (CEZ) 在食道切除术中的抗菌预防的疗效.
- 评估对短期术后结局的影响,包括手术部位感染,静脉泄漏和呼吸衰竭.
主要方法:
- 从日本住院患者数据库对17772名因癌症接受食道切除术的患者 (2010年7月至2019年3月) 的回顾性分析.
- 使用重叠倾向得分权重来比较ABPC/SBT和CEZ组之间的结果,调整为混因素.
- 敏感性分析包括倾向性得分匹配和仪器变量分析.
主要成果:
- 与塞法林 (CEZ) 相比,安皮西林-苏尔巴克坦 (ABPC/SBT) 与手术部位感染 (SSI) (OR 0.51),静脉泄漏 (OR 0.51),呼吸衰竭 (OR 0.66) 的发生率明显较低.
- 此外,ABPC/SBT还导致呼吸道并发症减少,住院时间缩短,总成本降低.
- 在Clostridioides困难性大肠炎或非传染性并发症中没有观察到显著差异.
结论:
- 西林-苏尔巴克坦 (ABPC/SBT) 显示出优越的短期术后结果,相比于塞法林 (CEZ),当用于消化管切除术的抗菌预防.
- 这些发现支持使用ABPC/SBT来改善食道切除术后患者的康复.
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