抗生素预防在预防前额鼻腔骨折管理后感染的有效性:回顾性分析
Apanjit Sahi1, Jeison De Guzman1, Grishma Patel1
1University of Maryland School of Medicine.
对额头鼻腔骨折 (FSF) 的抗生素预防没有显示出感染率的显著差异. 对所有FSF患者来说,抗生素可能不必要,特别是那些没有脑脊液泄漏的患者.
科学领域:
- 神经外科 神经外科
- 传染性疾病 传染性疾病
- 创伤外科 手术 创伤外科
背景情况:
- 额头鼻腔骨折 (FSF) 存在内感染的风险.
- 目前的文献显示,对FSF抗生素预防的有效性有不一致的证据.
- 最佳的管理策略需要进一步澄清.
研究的目的:
- 评估预防性抗生素在FSF后预防感染的疗效.
- 为FSF管理中使用抗生素提供基于证据的指导.
- 分析感染发病率与抗生素预防和持续/CSF参与有关.
主要方法:
- 追溯队列研究 (2018年1月至2022年12月).
- 纳入标准:年龄≥18岁的CT诊断FSF的患者.
- 主要结局:感染发生率;持续撕裂/CSF泄漏的二次分析.
主要成果:
- 包括201名患者;26名 (12.9%) 患有持续性撕裂或CSF泄漏.
- 在用抗生素管理的CSF泄漏患者中没有发生感染.
- 总体感染率:使用抗生素的3.1%,不使用抗生素的2.6% (P=1.0);观察到6种感染 (4种脑膜炎,2种鼻炎).
- 保守管理是常见的 (74%),包括所有患有感染的患者.
结论:
- 对所有前额骨折患者来说,抗生素预防可能不是普遍需要的.
- 需要进一步的随机对照试验来确定抗生素的作用.
- 抗生素可能对患有脑脊髓液泄漏的FSF患者有益,需要进一步调查.
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