在用活检进行结肠镜检查之前,抗生素预防并没有降低全膝关节整形手术接受者的假肢关节感染风险
Mohamed F Albana1, Daniel Hameed2, Sandeep S Bains2
1Lenox Hill Hospital Northwell Health, New York, NY, USA.
Journal of orthopaedics
|March 18, 2024
概括
侵入性结肠镜检查不会增加膝关节植入患者假肢关节感染 (PJI) 的风险. 根据这项研究,对于带有活检的结肠镜检查,抗生素预防可能是不必要的.
科学领域:
- 整形外科手术 整形外科手术
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
背景情况:
- 假肢关节感染 (PJI) 带来了重大风险和成本.
- 侵入性结肠镜和PJI之间的潜在联系正在调查中.
- 在PJI患者的结肠镜中缺乏对抗生素预防的临床指导.
研究的目的:
- 为了比较接受结肠镜检查的患者与没有抗生素预防的PJI率.
- 为了分析PJI发生的90天,6个月,9个月和1年后的过程.
- 评估抗生素预防对PJI率的影响,以告知临床指南.
主要方法:
- 一个全国性的,全付费者数据库被查询了190万个初级膝关节整形手术程序 (2010年1月至2020年10月).
- 之前有PJI或PJI的患者在索引程序的一年内被排除在外.
- 确定了三个队列:结肠镜与没有预防的活检,结肠镜与预防的活检,以及对照组 (没有先前的结肠镜).
主要成果:
- 在结肠镜和对照组之间90天,6个月,9个月或1年后没有观察到PJI率的显著差异.
- 结肠镜组的直接比较 (有和没有预防) 显示在任何时间点都没有显著的PJI率差异.
- 结肠镜队列之间的PJI的几率比率在1.07-1.43.3之间.
结论:
- 侵袭性结肠镜检查不会增加患有先前存在膝关节植入物的患者的PJI风险.
- 在接受结肠镜检查并计划进行活检的患者中,抗生素预防可能不需要.
- 研究结果表明,目前的临床指导方针可能不需要对这种患者群体内结肠镜检查的抗生素预防进行修改.
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