心内膜炎预防-指示,应用和当前的争议
Martin H Thornhill1, Mark J Dayer2, Bernard D Prendergast3
1Unit of Oral and Maxillofacial Medicine Surgery and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom.
The Canadian journal of cardiology
|October 16, 2025
概括
抗生素预防 (AP) 在接受牙科手术的高风险患者中有效预防传染性内心炎 (IE). 目前的指导方针平衡风险和益处,但最佳的患者和程序选择AP仍在争论中.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 牙科医学 牙科医学
背景情况:
- 预防感染性内心炎 (IE) 的抗生素预防 (AP) 建议自20世纪50年代以来一直在发展.
- 由于证据薄弱,过敏反应风险和抗生素耐药性的担忧,指导方针受到限制.
- 最近的数据表明,AP对于接受侵袭性牙科手术的高风险个人来说是安全有效的.
研究的目的:
- 审查当前关于IE预防AP的争议.
- 为了确定哪些患者和程序需要AP.
- 评估不同AP方案的安全性和成本效益.
主要方法:
- 最近文学作品的叙述性回顾.
- 对临床经验的分析.
- 讨论当前欧洲心脏病学会 (ESC) 和美国心脏协会 (AHA) 的指导.
主要成果:
- 最近的数据支持AP在降低牙科手术的高风险患者中IE发病率方面的有效性.
- 目前的ESC和AHA指南与这些发现保持一致.
- 关于最佳患者选择,手术指示和AP疗程,目前仍在进行辩论.
结论:
- 在某些高风险人群中,AP仍然是IE预防的宝贵工具.
- 需要进一步的研究来完善AP的患者和程序指示.
- 将IE预防与使用抗生素的风险相平衡至关重要.
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