需要针对手术前胆道排水,接受胰腺二切除术的患者制定针对性的术后抗生素治疗方案
Judith Camps-Lasa1, María Isabel García-Domingo1, Eric Herrero Fonollosa1
1Cirugía General y del Aparato Digestivo, Unidad HBP, Hospital Universitari Mutua Terrassa, Universitat de Barcelona (UB), Terrassa, Barcelona, Spain.
Cirugia espanola
|September 20, 2024
概括
在胰腺切除术患者的手术前胆道排水改变了细菌生物,增加了肠杆菌,肠球菌和菌. 向抗生素可以防止手术部位感染的差异,这表明需要对支架患者的预防方案进行修订.
科学领域:
- 肝胆道手术 肝胆道手术
- 手术感染 手术感染
- 微生物学 微生物学
背景情况:
- 胰腺双管切除术 (PD) 是一种复杂的手术,有可能导致手术部位感染 (SSI).
- 有时使用手术前的胆汁排水,可能会改变胆汁微生物群.
研究的目的:
- 为了比较患有和没有手术前胆道排水的PD患者中的细菌生物.
- 评估量身定制的外科手术期间抗生素治疗是否会影响这些群体之间的SSI率.
主要方法:
- 对127名PD患者的回顾性研究,分为具有 (组P) 和没有 (组NP) 手术前胆汁支架的患者.
- 在手术内分析培养物;根据预期的微生物学,使用向抗生素协议.
- 术后的SSI率和并发症在各组之间进行了比较.
主要成果:
- 组P显示了显著更高的积极的手术内培养率 (76.7%对16.7%),增加了Enterobacterales,Enterococcus spp.和Candida.
- 尽管细菌生物有所不同,但SSI的发病率相似 (23.2%在P组和17.8%在NP组).
- 两组之间没有观察到总体发病率或死亡率的显著差异.
结论:
- 术前胆道支架显著改变细菌生物,增加特定微生物的流行.
- 针对性的外科手术期间的抗生素策略在缓解SSI差异方面似乎是有效的,尽管细菌生物多样化.
- 研究结果表明,对于带有胆道支架的PD患者,重新评估标准手术预防是有必要的.
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