在患有肠道衰竭的儿科患者中进行内镜后发烧和感染
Johannes Hilberath1, Omar Afrigh1, Toni Illhardt1
1Paediatric Gastroenterology and Hepatology, Department of Haematology and Oncology, University Children's Hospital Tübingen, Tübingen, Germany.
Journal of pediatric gastroenterology and nutrition
|July 4, 2025
概括
对于经过胃肠道内镜检查的肠衰竭 (IF) 的儿童,不建议进行常规抗微生物预防 (AMP). 这项研究发现,AMP在这个高危人群中没有预防后内镜发烧或感染.
科学领域:
- 儿科胃肠病学 儿科胃肠病学
- 传染性疾病 传染性疾病
- 临床医学 临床医学
背景情况:
- 常规抗微生物预防 (AMP) 通常不建议用于儿科胃肠道 (GI) 内镜.
- 患有肠衰竭 (IF) 和中央静脉导管 (CVC) 的儿童代表了一个独特的高风险人群.
- 在这些儿童中,AMP在预防后内镜发烧 (PEF) 和感染方面的疗效尚未得到充分证实.
研究的目的:
- 为了评估IF和CVC的儿童在GI内镜检查后的发烧和感染率.
- 确定AMP在这个特定的儿科患者群体中的作用和有效性.
- 评估政策变化对2022年常规AMP终止的影响.
主要方法:
- 对经过肠道内镜检查的IF和CVC儿童进行了回顾性,单中心的观察性研究 (2019-2024).
- 在2022年政策变更后,静脉注射AMP和未注射AMP的患者之间的结局比较.
- 使用千平方和曼-惠特尼U测试进行统计分析.
主要成果:
- 在108名患者中,共分析了233个内镜; 71.2%的患者接受了AMP.
- 总体后内镜发烧 (PEF) 率为6%,AMP和无AMP组之间没有显著差异.
- 在这两组中都没有观察到任何感染,包括与中枢线相关的血液感染.
结论:
- 患有FI的儿童的PEF率明显高于一般儿科患者.
- 抗微生物预防 (AMP) 没有证明在这个队列中预防PEF或感染有好处.
- 在患有IF和CVC的儿童中,用于诊断内镜的常规AMP注射不适用.
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