在vNOTES中的抗菌预防策略:没有共识,但我们知道什么?
Ipek Betul Ozcivit Erkan1, Savci Bekir Telek2, Koray Gorkem Sacinti3
1Department of Anatomy, Institute of Graduate Sciences, Istanbul University-Cerrahpasa, Istanbul, Turkey.
European journal of obstetrics, gynecology, and reproductive biology
|September 5, 2025
概括
阴道自然孔透光内镜手术 (vNOTES) 的感染率较低,与传统方法相比或低. 目前的抗生素预防缺乏标准化,通常使用的是类药物.
科学领域:
- 妇科手术
- 最少的入侵性手术
- 传染病预防
背景情况:
- 阴道自然孔透光内镜手术 (vNOTES) 是一种新兴的妇科手术技术,结合了阴道和腹腔镜的方法.
- 目前缺乏针对vNOTES程序的标准化抗生素预防指南.
- 评估感染率和当前的预防措施对于优化患者的治疗结果至关重要.
研究的目的:
- 审查和评估与vNOTES程序相关的感染率.
- 评估vNOTES手术中的当前抗生素预防实践.
- 在vNOTES中提供抗生素预防的建议.
主要方法:
- 在PubMed/MEDLINE和Cochrane图书馆进行了全面的文献搜索.
- 研究根据手术类型进行分类:vNOTES子宫切除术,副手术和其他vNOTES手术.
- 提取的数据包括感染率,抗菌剂使用情况和患者人口统计数据.
主要成果:
- 对9,173例vNOTES病例的分析显示,在各种手术中感染率很低,包括子宫切除手术,附带手术和其他手术.
- 与非vNOTES手术相比,vNOTES子宫切除手术的感染率通常较低.
- 对抗生素预防方案的报道不一致,第一代头素或头素组合是最常见的.
结论:
- 对于vNOTES手术的抗生素预防没有确定的共识.
- 目前的证据表明vNOTES不会增加手术后感染的风险.
- 需要进一步的前性研究来制定最终的预防指南.
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