经过复杂尾炎手术后的短期抗生素治疗是否与长期治疗一样安全和有效? 一个系统的审查和元分析
Kai Lu1, Shilong Shu1, Xuefeng Peng1
1Department of General Surgery, Zigong Fourth People's Hospital, Zigong, 643000, Sichuan Province, China.
对复杂尾炎 (CA) 进行尾切除术后的短期抗生素 (SCA) 治疗与长期抗生素 (LCA) 治疗一样安全和有效. 这种方法可以减少抗生素的消耗,而不会增加手术部位感染或腹内的风险.
科学领域:
- 传染性疾病 传染性疾病
- 外科手术的结果
- 基于证据的医学基于证据的医学.
背景情况:
- 短期抗生素治疗 (SCA) 越来越多地被考虑用于尾切除术后复杂尾炎 (CA).
- 与传统的长期抗生素治疗 (LCA) 相比,现有的元分析缺乏足够的关于SCA安全性和有效性的数据.
研究的目的:
- 评估SCA治疗与CA尾切除术后LCA治疗的安全性和有效性.
- 确定SCA治疗是否会增加手术部位感染 (SSI) 或腹内 (IAA) 的风险.
主要方法:
- 一项对四项随机对照试验 (RCT) 和九项观察性研究的元分析.
- 涉及3251名接受CA尾切除术的患者.
- 使用RevMan 5.3分析数据,并使用GRADE方法评估证据质量.
主要成果:
- 与LCA治疗相比,不到3天的SCA治疗没有显著增加SSI风险 (低质量的证据) 或IAA风险 (中等质量的证据).
- 在SCA和LCA疗法之间的二次结果中没有发现显著差异 (中等到非常低质量的证据).
- SCA治疗与更短的住院时间有关 (低质量的证据).
结论:
- 短期抗生素治疗 (少于3天) 是对复杂尾炎的尾切除术后的安全有效选择.
- 减少抗生素的持续时间可以最大限度地减少不必要的抗生素消耗.
- 在不影响患者安全的情况下,SCA治疗可能会导致更短的住院时间.
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