评估无并发性尾炎中术后抗生素的必要性:系统性审查和元分析
Yousef Kurdi1, Rayouf Alqahtani2, Nujud Bin Khunayn3
1King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
BMC surgery
|November 2, 2025
概括
对于不复杂的尾炎,手术前的抗生素显著改善了结果,缩短了住院时间. 常规的术后抗生素没有额外的益处,并且增加了不良事件的风险,支持抗菌药物管理.
科学领域:
- 手术紧急情况管理
- 传染病药理学 传染病药理学
- 基于证据的医学基于证据的医学.
背景情况:
- 急性尾炎是一个普遍存在的全球手术紧急情况.
- 术后抗生素对无并发性尾炎的作用仍在争论中.
- 这一元分析调查了抗生素时间对结果和安全的影响.
研究的目的:
- 评估手术前与术后抗生素在无并发性尾炎中的疗效.
- 评估对患者结果,不良事件和住院时间的影响.
- 为临床指导方针和抗微生物药物管理实践提供信息.
主要方法:
- 14项研究 (15年) 的系统审查和元分析.
- 包括实验和观察性研究 (14-65岁的患者).
- 使用SPSS,Excel,RevMan进行统计分析;通过Cochrane工具评估偏差风险.
主要成果:
- 手术前的抗生素显著减少了住院时间和并发症.
- 手术后的抗生素与不良事件 (C. difficile,SSI,UTI) 的增加相关.
- 仅接受手术前抗生素治疗的患者表现更好.
结论:
- 术前的抗生素 (例如,美特罗尼达,塞福西丁) 对于无并发的尾炎是足够的.
- 手术后的抗生素没有额外的益处,增加了不良事件的风险.
- 这些发现支持将抗生素限制在术前阶段,以获得更安全,更具成本效益的护理.
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