在选择性和紧急结肠直肠手术中,术后抗生素计时的重要性
Sarah Peisl1, Guido Beldi1, Rami Sommerstein2,3,4
1Department of Visceral Surgery and Medicine, Bern University Hospital, University of Bern, Switzerland.
Journal of the American College of Surgeons
|November 10, 2025
概括
在结直肠手术中切口前最佳的抗生素时间,特别是紧急手术,显著影响30天死亡率. 在切口前大约50分钟服用抗生素可以最大限度地降低死亡风险,这凸显了精确的术后抗生素定时的重要性.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 传染病流行病学 传染病流行病学
- 在外科手术期间的医学.
背景情况:
- 术后抗生素预防对于结直肠手术的结果至关重要.
- 制定了选修程序的指导方针,但紧急设置缺乏可靠的证据.
- 这项研究调查了抗生素定时对死亡率和手术部位感染 (SSIs) 在紧急结直肠手术中的影响.
研究的目的:
- 评估切口前抗生素的时间与30天死亡率之间的关联.
- 在紧急结直肠手术中评估抗生素时间和手术部位感染 (SSI) 之间的关系.
- 确定最佳的抗生素时间,以改善紧急结直肠手术后术后果.
主要方法:
- 全国回顾性队列研究,使用瑞士国家感染监测数据.
- 对人口统计,抗生素治疗方案和外科特征的分析,比较可选和紧急病例.
- 多变量后勤回归和自然立方线,以确定预测因素,并模拟抗生素定时对死亡率和SSI的非线性影响.
主要成果:
- 在选择性和紧急结直肠手术中,抗生素服用时间与30天死亡率有显著的相关性 (p < 0.001).
- 观察到U型模式,当切口前大约48-51分钟服用抗生素时,死亡风险最低.
- 在抗生素服用时间和手术部位感染 (SSI) 之间没有发现显著的关联 (p = 0.229).
结论:
- 与切口相比,早期和晚期的抗生素给药都增加了结直肠手术中的30天死亡率.
- 在选择性和紧急结直肠手术中,当切口前大约50分钟服用抗生素时,就能获得最佳的结果.
- 研究结果强调,需要优化外科手术期间的抗生素治疗时间,以改善紧急结直肠手术患者的治疗结果.
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