术前抗生素对ERCP后感染性不良事件的影响,其中包括远端恶性胆道阻塞
Tatsunori Satoh1,2, Haruna Takahashi1, Eiji Nakatani3
1Department of Gastroenterology, Shizuoka General Hospital, Shizuoka, Japan.
Journal of gastroenterology and hepatology
|December 30, 2025
概括
在内镜逆行性胆管松造影 (ERCP) 之前给予的预防性抗生素显著减少了患有远端恶性胆道阻塞 (DMBO) 患者的手术后感染. 这一发现表明,在这个患者群体中使用抗生素可能有好处.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
背景情况:
- 恶性胆道阻塞 (MBO) 往往需要内镜逆行胆道细胞造影 (ERCP) 来进行胆道排水.
- ERCP后的感染,如胆管炎和胆囊炎是严重的担忧,目前的指导方针只建议高风险患者服用抗生素.
- 有限的数据存在于围绕ERCP抗生素的有效性,特别是在进行支架安置的远端MBO (DMBO) 患者.
研究的目的:
- 评估PERI-ERCP抗生素对DMBO患者传染性不良事件发生率的影响.
- 评估这种特定患者群体中抗生素预防的安全性和有效性.
主要方法:
- 一项多中心的回顾性研究,涉及508名接受DMBO初始胆汁支架安置的患者.
- 患者被分为接受或不接受PERI-ERCP抗生素的组.
- 倾向性得分匹配 (1:1) 用于控制混变量,主要结局是ERCP后5天内的传染性不良事件.
主要成果:
- 在倾向分数匹配后,在每个组中分析了165名患者.
- 与非抗生素组 (10.3%) 相比,抗生素组 (3.6%) 的传染性不良事件发生率明显较低.
- 亚组分析表明,非胰腺癌或胆道直径超过10毫米的患者的益处更大.
结论:
- 在ERCP期间服用抗生素似乎可以降低DMBO患者ERCP后传染性不良事件的风险.
- 这些发现表明,在接受ERCP的DMBO患者中,常规抗生素预防可能发挥作用.
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