优化手术前护理:比较单独的机械肠道制备与结合性口服抗生素在结肠直肠癌手术中的比较
Kainaat Salaria1, Yamin Manzoor Bhat1, Imad Banday1
1Department of General and Minimal Invasive Surgery, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar India.
Indian journal of surgical oncology
|November 24, 2025
概括
将口服抗生素添加到机械肠道制备中,可以显著减少手术部位感染和结肠直肠癌手术中的静脉漏. 这种组合增强了患者的安全性,并改善了与单独的机械肠道准备相比,手术的结果.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 预防传染病 预防传染病
背景情况:
- 机械肠道准备 (MBP) 是结直肠外科手术的标准实践,以减少术后并发症,但其有效性仍在争论中.
- 将MBP与口服抗生素 (OA) 结合使用可能会进一步减少手术部位感染 (SSI) 和静脉漏,特别是在高风险的手术中.
研究的目的:
- 为了比较单独使用MBP与与OA一起使用MBP在减少SSI,静脉漏以及选择性结直肠手术中其他术后并发症的有效性.
主要方法:
- 一项准实验性研究涉及99名接受结直肠癌手术的患者.
- 患者被分为两组:A组 (n=33) 仅接受MBP,B组 (n=66) 接受MBP与利法西明 (OA).
- 评估了手术后的结局,包括SSI,静脉漏,大肠和死亡率,统计学意义为p < 0.05.
主要成果:
- 与A组相比,B组的SSI (9%与18%,p=0.045) 和道泄漏率 (7.5%与12%,p=0.039) 显着较低.
- 两组之间没有发现大脑或死亡率的显著差异.
- 没有患者需要再入院,MBP通常耐受良好.
结论:
- 在选择性结直肠手术中,MBP和OA的组合显著降低了SSI和直肠泄漏.
- 将OA整合到手术前方案中可以提高结直肠癌手术的外科结果和患者安全,而不会增加不良事件.
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