预防性抗生素在儿科 inguinal hernia 手术中的最小影响:来自现实世界的证据
Takayuki Fujii1, Yuri Kitadani2, Aya Tanaka1
1Department of Pediatric Surgery, Faculty of Medicine, Kagawa University, 1750-1, Ikenobe, Mikicho, Kitagun, Kagawa 761-0793, Japan.
Journal of pediatric surgery
|August 25, 2025
概括
预防性抗生素不能减少手术部位感染 (SSI) 在儿科 inguinal 修复. 抗生素的使用应保留给高风险患者,例如那些接受免疫抑制剂的患者.
科学领域:
- 儿童手术
- 预防传染病
- 临床结果研究
背景情况:
- 预防性抗生素的必要性对于儿科 inguinal 修复是有争议的, 因为这是一个干净的程序.
- 目前关于抗生素在儿童群体中的有效性的证据有限.
研究的目的:
- 评估预防性抗生素在儿童手术修复后减少手术部位感染 (SSI) 的有效性.
- 在此患者群体中确定与SSI相关的风险因素.
主要方法:
- 使用TriNetX研究网络进行的回顾性队列研究.
- 包括接受开放式或腹腔镜 inguinal hernia 修复的儿科患者 (≤16岁) (2005-2025年).
- 用于比较抗生素和非抗生素组之间的结果,按手术方法和风险分类分层.
主要成果:
- 对42,779名患者的分析显示,在开放和腹腔镜修复过程中,预防性抗生素并没有显著减少SSI.
- 在不接受抗生素治疗的患者中,无论手术方法或风险分类,SSI的发病率仍然很低 (≤0. 40%).
- 男性的性别,年龄< 6个月,以及免疫抑制剂的使用被确定为重要的SSI预测因素.
结论:
- 预防性抗生素不会降低儿童椎修复的SSI率.
- 抗生素的使用应限于选择高风险的儿科患者,特别是那些服用免疫抑制剂的患者.
- 进一步的研究可能会完善这种常见的儿科手术的抗生素管理准则.
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