在转向环节结肠切除术闭合后,直肠癌患者的闭肠切除术难以感染
Chirurgia (Bucharest, Romania : 1990)
|March 11, 2024
概括
癌症患者在直肠外科手术后接受静脉关闭,面临更高的Clostridium difficile感染风险. 延迟三个月以上的静脉缩逆转,特别是结合抗生素和质子抑制剂治疗,显著增加了这种风险.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 传染性疾病 传染性疾病
背景情况:
- 困难菌感染 (CDI) 在住院患者,特别是癌症患者的患病率和死亡率显著增加.
- 诸如晚年,抗生素使用,质子抑制剂 (PPI) 和化疗等因素使癌症患者易患CDI.
- 乳房骨架逆转术是直肠癌手术后的常见手术.
研究的目的:
- 在直肠癌患者中,确定经过结肠静止术逆转后困难菌感染的患病率.
- 为了确定与此患者队列中CDI发展相关的风险因素.
主要方法:
- 一项回顾性研究分析了从直肠癌患者获得的数据,这些患者在4年的时间内接受了转向环节性静脉切除术的逆转.
- 该研究包括由单一外科小组进行手术的患者,比较开放式和腹腔镜初始手术.
- 收集了关于结节管关闭时间,术后药物 (抗生素,PPI) 和化疗的数据.
主要成果:
- 在63名患者中,23名 (36.5%) 患有困难菌感染.
- 所有的CDI病例都发生在患者中,这些患者的静脉关闭是在初级手术后3个月后进行的.
- 这些患者还在术后24小时内接受了外科手术期间的抗生素治疗和质子抑制剂.
结论:
- 在初级直肠癌手术后3个月以后进行的乳房静脉逆转与CDI的风险增加有关.
- 延迟静脉切开关闭,化疗,抗生素治疗和质子抑制剂的结合进一步提高了直肠癌幸存者的Clostridium difficile感染的风险.
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