与单独使用塞法林相比,美特罗尼达醇加塞法林用于手术部位感染的预防,用于切除子宫的患者:系统性审查

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Monica M Jackson¹, Logan R Eckhardt¹, Michael Zamani²

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概括

将美特罗尼达添加到塞法林显著降低了切除子宫术后手术部位感染 (SSI) 的风险. 这种组合疗法,特别是静脉注射的美特罗尼达,与单独使用塞法林相比,提供了更好的预防.

科学领域:

妇科妇科妇科妇科
预防传染病预防传染病
外科手术的结果

背景情况:

手术部位感染 (SSI) 是子宫切除术后的一个常见并发症.
目前的预防指导方针经常建议单独使用塞法林.
在SSI预防方面,添加美트로尼达到塞法林的疗效需要进一步评估.

研究的目的:

系统地审查关于添加美特罗尼达到塞法索林在切除子宫术后预防手术部位感染 (SSI) 的有效性.
为了比较塞法佐林加上美트로尼达与单独的塞法佐林在降低SSI率方面的疗效.

主要方法:

在多个数据库 (MEDLINE,ClinicalTrials.gov,EMBASE,Cochrane Library,Web of Science) 进行了全面的文献搜索,截至2024年10月.
包括的研究是1980年至2024年的同行评审研究,涉及经过子宫切除术的患者,比较使用或不使用甲尼达的塞法佐林,并在30天内报告SSI.
5,838名参与者参与的五项研究 (两个RCT,三个观察性) 符合资格标准.

主要成果:

阴道和静脉注射 (IV) 的甲尼达,当添加到塞法林时,表明SSI的风险质量较低.
随机对照试验 (RCT) 显示,SSI与阴道美트로尼达的几率比 (ORs) 为0.28和0.43.
观察性研究报告的ORs为0.40-0.63的SSI与IV美트로尼达,在最大的研究中具有统计学意义.

结论:

添加美特罗尼达 (metronidazole) 到塞法佐林 (cefazolin) 得到证据支持,证据表明,切除子宫术后可降低SSI风险.
因其有效性,静脉注射的甲尼达可能是患者和外科医生都喜欢的注射途径.
用更大的样本规模进行进一步的研究可以加强有关SSI预防的调查结果的统计力.

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