预防性静脉注射抗生素在甲状腺通道和分支裂囊切除中的使用:NSQIP-P分析
Cyrus W Abrahamson1, Thomas Q McClelland1, David J Fei-Zhang2
1Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.
概括
预防性静脉注射抗生素 (PIAB) 在小儿甲状腺管和分支裂囊切除中的使用显示了多种模式,但并不总是改善结果. 重新评估PIAB的必要性对于制定儿科部大规模手术的基于证据的指导方针至关重要.
科学领域:
- 儿科手术 儿科手术
- 手术瘤学手术瘤学
- 传染性疾病 传染性疾病
背景情况:
- 甲状腺管囊 (TGDC) 和分支裂囊 (BCC) 是常见的儿科部质量.
- 预防性静脉注射抗生素 (PIAB) 经常用于它们的外科切除,但它们的有效性仍有争议.
研究的目的:
- 在儿科TGDC和BCC切除中分析PIAB使用模式.
- 为了确定PIAB的使用是否会影响患者的治疗结果,例如手术部位感染,再入院和重新手术.
主要方法:
- 使用美国外科医生学院国家外科质量改善计划-儿科 (NSQIP-P) 数据库进行回顾性队列研究.
- 对2021-2023年接受TGDC或BCC切除的儿科患者 (≤18岁) 的分析.
- 多变量回归模型评估了PIAB使用与关键结果之间的关联,控制了临床人口统计因素.
主要成果:
- 观察到PIAB使用率很高 (83.5%为TGDC,68.0%为BCC).
- PIAB的使用与种族,入院状态和伤口分类等因素相关.
- 多变量分析显示,PIAB使用与任何队列中感染,再入院或重新手术率的降低之间没有显著的关联.
结论:
- 在儿科部大规模手术中使用PIAB受临床人口统计因素的影响,但缺乏改善患者结果的一致证据.
- 这些发现表明,需要批判性地重新评估目前关于TGDC和BCC减税的PIAB的做法.
- 建议进行进一步的研究,以建立基于证据的指导方针,用于儿童部大规模手术中的抗生素预防.
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