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在内镜外科手术后有毒冲击综合征的发生率和危险因素:系统性审查
Jillian O'Shaughnessy1, Jerlon Chiu1, Timothy Shim2
1Division of Otolaryngology, Stony Brook School of Medicine, Stony Brook, New York, USA.
概括
毒性休克综合征 (TSS) 是经过鼻手术后的一种罕见并发症,每10万个人中约有30人发生. 预防性抗生素和鼻包装并没有预防TSS,但随着及时管理,结果是有利的.
科学领域:
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 传染性疾病 传染性疾病
- 手术并发症 手术并发症
背景情况:
- 毒性休克综合征 (TSS) 是经过鼻手术后的一种罕见但严重的并发症.
- 在鼻腔外科手术后TSS的先前报告主要局限于病例研究或小患者系列.
- 鼻包装和预防性抗生素通常被认为是预防TSS在鼻腔手术后.
研究的目的:
- 系统地审查和描述TSS在内镜外科手术 (ESS) 和/或阴道整形术后的发病率,风险因素和临床过程.
- 为了提供一个全面的概述的TSS作为一个并发症在鼻外科手术.
- 为了确定潜在的风险因素和患者结局与TSS相关的TSS和/或血栓形成术后TSS.
主要方法:
- 通过使用多个主要科学数据库 (MEDLINE,EMBASE,CINAHL,Web of Science,Cochrane Library) 进行了相关文献的系统审查.
- 资格标准包括任何年龄的患者,他们患有TSS作为ESS和/或血栓形成手术的并发症.
- 数据提取集中在发病率,患者人口统计,手术细节,管理和结果上.
主要成果:
- 在38年的时间 (1982-2020年) 中,经过鼻腔手术后TSS的综合发病率为0.0003 (每10万人中30人),70例确诊病例.
- 在已有数据的患者中,51.5%的患者有鼻包装,9.1%的患者有支架,42.4%的患者有不可吸收的包装.
- 48%的患者接受了预防性外科期抗生素治疗,97%的患者完全康复.
结论:
- 在鼻腔外科手术后出现TSS的发病率极为罕见.
- 无论鼻塞如何,TSS都可能发生,并且没有发现预防性抗生素对其发展有保护作用.
- 早期识别和适当管理TSS导致有利的患者结果,尽管需要进一步的研究来确定高风险个体.
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