在全关节整形术后进行牙科手术的抗生素预防:系统性审查和元分析
Michael T Mullen1, Marlena K Urvater1, Emma Hillis2
1University of Queensland, Ochsner Clinical School, New Orleans, Louisiana.
The Journal of arthroplasty
|September 11, 2025
概括
牙科手术前的预防性抗生素并不能降低在全关节整形术 (TJA) 后周围假肢关节感染 (PJI) 的风险. 建议将抗生素使用限制在高风险患者身上,以改善抗生素管理.
科学领域:
- 整形外科手术 整形外科手术
- 传染性疾病 传染性疾病
- 公共卫生 公共卫生
背景情况:
- 周围假肢关节感染 (PJI) 是整体关节整形术 (TJA) 的重要并发症.
- 牙科手术的血液传播是PJI的潜在原因.
- 讨论了TJA患者牙科手术前抗生素预防的当前指导方针.
研究的目的:
- 评估牙科手术前抗生素预防与PJI风险之间的关联.
- 通过系统审查和元分析来综合证据.
主要方法:
- 在PubMed,Embase和Cochrane数据库中的系统文献搜索.
- 包括四个回顾性队列研究,包括157,466名TJA患者.
- 进行了随机效应的元分析,以对PJI风险的概率比率进行比较.
主要成果:
- 没有研究表明抗生素预防后PJI率有显著降低.
- 分析显示,抗生素和非抗生素组之间的PJI风险没有显著差异.
- 确定了修复关节整形手术,肥胖和糖尿病作为其他PJI风险因素.
结论:
- 在牙科手术前的常规抗生素预防不能降低初级TJA患者的PJI风险.
- 有证据支持限制预防,以选择高风险人群.
- 这些发现提倡加强抗生素管理和更新临床指南.
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