预防性抗生素对腹腔镜皮洛洛米奥托米的实用性
Kristine L Griffin1, Brandon Rodgers2, Hannah Rinehardt3
1Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio.
The Journal of surgical research
|May 24, 2024
概括
手术前的抗生素不会影响婴儿高性胆道狭窄症的腹腔镜胆道缩小术中手术部位感染率. 抗生素的使用在外科医生之间有很大差异,这表明需要标准化的协议来减少不必要的预防.
科学领域:
- 儿科手术 儿科手术
- 手术感染 手术感染
- 抗生素管理局 抗生素管理局
背景情况:
- 婴儿过度缩小的胆道狭窄症 (IHPS) 的 laparoscopic pyloromyotomy (LP) 是手术部位感染 (SSI) 的低风险手术.
- 现有文献显示,尽管预期的SSI率较低,但LP的预防性抗生素的使用变化很大.
研究的目的:
- 评估手术前抗生素给药与在接受IHPSLP治疗的患者中SSI发生率之间的关联.
- 为了确定外科医生进行LP的预防性抗生素利用的变化.
主要方法:
- 从2017年1月到2020年6月,对227名4个月以下的患者进行了回顾性分析,这些患者从2017年1月到2020年6月为IHPS接受了LP.
- 排除失去了随访的患者或需要在手术内转换为开放手术的患者.
- 使用费舍尔的精确测试和独立的t测试进行统计分析,以比较SSI率和患者特征.
主要成果:
- 39%的患者接受了手术前的抗生素治疗;整体SSI率为1.3%.
- 在接受手术前抗生素 (1.1%) 和未接受 (1.4%) 的患者之间,没有观察到SSI发生率的显著差异.
- 在个别外科医生中,发现了抗生素处方实践的显著变化.
结论:
- 对于IHPS的腹腔镜性pyloromyotomy中,手术前使用抗生素与手术部位感染率的降低无关.
- 目前对LP的抗生素使用显示出相当大的差异,表明需要更新指南以优化预防性抗生素的使用.
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