儿童用口服抗生素进行机械肠道制备:必要的步骤还是不必要的负担?
Krysta M Sutyak1, Molly Anapolsky2, Victor M Ringheanu2
1Department of Pediatric Surgery, McGovern Medical School, University of Texas Health Science Center at Houston, Children's Memorial Hermann Hospital, Houston, Texas; Center for Surgical Trials and Evidence-Based Practice (CSTEP), McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas.
使用口服抗生素 (MBP+OA) 进行机械性肠道制备,在儿科结直肠手术中,整体手术部位感染 (SSI) 没有显著差异. 然而,MBP+OA可能会减少严重的器官空间感染,需要进一步调查.
科学领域:
- 儿科手术 儿科手术
- 传染病控制和控制传染病
- 结肠直肠手术 结肠直肠手术
背景情况:
- 手术部位感染 (SSI) 是儿科结直肠外科手术的一个问题.
- 使用口服抗生素 (MBP+OA) 进行机械性肠道制备是成年人的标准,但缺乏儿科数据.
- MBP+OA涉及入院前和鼻胃 (NG) 管的放置,增加了复杂性.
研究的目的:
- 评估MBP+OA和SSI比率在接受选择性结直肠手术的儿科患者之间的关联.
- 将MBP+OA与单独的机械肠道制备或没有肠道制备 (NBP) 进行比较.
主要方法:
- 对非新生儿儿科患者 (<18岁) 进行选择性结肠直肠切除的回顾性研究.
- 收集的数据:人口统计,病史,抗生素使用,肠道制备类型,NG管使用和30天的SSI.
- 统计分析包括奇平方,曼-惠特尼U,以及逻辑回归 (频率主义和贝叶斯主义).
主要成果:
- 包括100名患者;61%接受了MBP+OA,80%通过NG管.
- 总体上,SSI率为19% (20%NBP对20%MBP+OA;P=0.91). 这一比例为19% (NBP为20%,MBP+OA为20%,P=0.91).
- 调整后的分析显示,MBP+OA和NBP之间的复合SSI没有差异 (OR0.78). 器官空间感染仅在NBP组中发生 (99%的贝叶斯概率对MBP+OA有益).
结论:
- 为小儿结直肠手术做好最佳肠道准备需要进一步研究.
- MBP+OA在整体SSI中没有显著差异,但可能会减少器官空间感染.
- 需要更强大的研究来确认MBP+OA在儿科患者中的有效性.
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