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重新评估在儿科皮洛里诺骨关节切除术中的手术抗生素预防:来自NSQIP-儿科数据库的见解

Shachi Srivatsa¹, Megan Read², Brenna Rachwal²

¹Center for Surgical Outcomes Research, Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH, USA; Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA.

Journal of pediatric surgery

|April 30, 2025

概括

对于接受pyloromyotomy的婴儿,手术抗生素预防 (SAP) 不需要,因为它不会降低手术部位感染 (SSI) 率. 在低风险婴儿中省略SAP可以帮助打击抗菌素耐药性.

科学领域:

儿科手术儿科手术
传染病管理传染病管理
抗生素管理局抗生素管理局

背景情况:

对于过度缩小的胆管狭窄症而言,胆管缩小术是一种低风险的干净手术程序.
常规的手术抗生素预防 (SAP) 是常用的,这引发了对抗生素耐药性的担忧.
需要证据来确定SAP在减少手术部位感染 (SSIs) 的有效性.

研究的目的:

为了评估SAP对接受pyloromyotomy的婴儿SSI率的影响.
制定指导方针,用于选择性省略小儿肺结核切除术中的SAP.

主要方法:

使用国家外科质量改善计划-儿科数据库进行回顾性队列研究.
对2021年1月1日至2023年12月31日期间的数据进行分析,包括经过脊髓瘤切除术的婴儿 (<1岁).
主要结局:手术后30天的SSI率;次要结局:分层的SSI类型,再入院和返回OR.

主要成果:

在4917名婴儿中,49.48%接受了SAP. 总体上,SSI率为1.42%的情况.
在接受SAP (1.15%) 和未接受SAP (1.69%;p=0.110) 的婴儿之间,SSI率没有显著差异.
手术后使用抗生素和SAP并没有显著影响再录取或返回OR率.

结论:

由于SSI风险较低,常规的SAP在pyloromyotomy中是不必要的.
对于没有特定复杂因素的低风险婴儿 (ASA类 I/II) 建议选择性SAP遗漏.
研究结果支持在儿科手术中优化抗生素管理.

关键词:

抗生素预防抗生素预防抗生素管理的管理.皮洛罗米奥托米 (Pyloromyotomy) 是一种肌肉切除术.

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