抗生素和手术治疗急性尾炎,什么时候,在哪里,为什么?
Andrew Hendrix1, Alexander Kammien2, Adrian A Maung2
1University of South Carolina School of Medicine, Columbia, South Carolina, USA.
Surgical infections
|February 20, 2025
概括
切口前抗生素 (POA) 在接受紧急尾切除术的患者中没有减少手术部位感染 (SSIs),这些患者已经接受了急诊部抗生素 (EDA). 穿孔和男性性别等因素与器官空间SSI有关,而不是POA.
科学领域:
- 手术感染预防 手术感染预防
- 紧急医疗 紧急医疗
- 抗生素管理局 抗生素管理局
背景情况:
- 切口前抗生素 (POA) 是干净污染手术的标准,以减少手术部位感染 (SSI).
- 由于腹部内感染而接受紧急手术的患者经常接受急诊室抗生素 (EDA),可能会否定POA的益处.
- 这项研究调查了POA在紧急尾切除术患者的疗效,这些患者已经接受EDA治疗.
研究的目的:
- 为了确定切口前塞法索林是否可以降低紧急尾切除术患者的SSI.
- 在这个患者群体中确定与SSI相关的因素.
主要方法:
- 对1380名接受紧急尾切除术的患者 (2013-2020年) 的回顾性审查.
- 抽象的数据包括人口统计,尾炎的严重程度,并发症和抗生素的使用 (EDA和POA).
- 后勤回归模型评估了POA和其他因素对表面/深层和器官空间SSI的影响.
主要成果:
- POA没有预测SSI (p=0.632).
- 穿孔 (OR: 17.08) 和男性性别 (OR: 2.75) 与器官空间SSI相关;切口前的zolin没有 (OR: 0.83).
- 紧急部门的宽谱抗生素 (EDA) 与较低的表面/深层感染有关 (OR:0.06),但切口前的塞法佐林没有 (OR:0.71).
结论:
- 在接受EDA的紧急尾切除术患者中,额外的切口前塞法索林并不能减少SSI.
- 专注于及时的EDA和管理诸如穿孔和性别等因素可能更为关键的SSI预防在这个群体.
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