用PEN-FAST得分重新引入青素减少了面外科手术中的传染性并发症
E Bouillien1, Q Hennocq1, J P Foy1
1Sorbonne Université, Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France.
Journal of stomatology, oral and maxillofacial surgery
|February 5, 2026
概括
PEN-FAST评分可以安全地识别出利面外科手术中利素过敏风险较低的患者. 在这些患者中重新引入青素改善了结果,并减少了并发症.
科学领域:
- 面外科手术 面外科手术
- 临床决定规则 临床决策规则
- 传染病管理 传染病管理
背景情况:
- 自我报告的青素过敏是口外科手术中最佳抗生素选择的常见障碍.
- PEN-FAST评分 (青素过敏,过去五年内,过敏反应/血管,严重的皮肤不良反应,过敏发作需要治疗) 是评估真正青素过敏风险的验证工具.
研究的目的:
- 评估西林重新引入的安全性和有效性,在口外科手术患者中,根据PEN-FAST得分被确定为非常低风险.
- 评估不使用青素对感染并发症和医疗保健利用的影响.
主要方法:
- 针对接受大脸部手术的成年患有自我报告的青素过敏患者进行前性,干预性,单中心研究.
- 对所有患者进行PEN-FAST得分计算;对于得分为0.0的患者,重新引入青素.
- 主要结局:不良反应和感染性并发症. 二次结局:手术部位感染 (SSI),严重的传染性并发症 (SIC),停留时间和手术干预次数.
主要成果:
- 在74名患者中,41人 (55%) 的PEN-FAST得分为0. 在这些患者中,29名 (71%) 患者安全地恢复了青素,没有任何不良反应.
- 不使用青素独立地与显著更高的SSI或SIC风险相关 (OR=31.54,p=0.002).
- 不使用青素与长时间住院 (IRR=1.86,p=0.012) 和增加手术干预 (IRR=1.41,p=0.018) 相相关.
结论:
- 以PEN-FAST得分为指导的青素再注射对于口外科手术中风险非常低的患者是安全有效的.
- 实施PEN-FAST评分可能会降低传染性并发症并减少医疗保健资源利用率.
- 这种方法支持优化抗生素处方,并改善这个手术群体中患者的治疗结果.
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