Padrón-Sánchez A, Ochoa-Zaldivar L, López-Flores G, García-Maeso I, Barnés-Domínguez J A, Reconde-Suárez D
Servicio de Neurocirugía, Centro Internacional de Restauración Neurológica (CIREN), La Habana, Cuba.
Rev Neurol. 1999;29(11):1020-3.
Stereotaxic surgery is becoming increasingly important because of the possibility of approaching the deep zones of the brain with less risk. It is in daily use in cerebral tumours and in the functional surgery of Parkinson's disease. The use of antibiotic prophylaxis in neurosurgery is controversial, although in many centres, including ours, all patients receive it.
To study the pre-operative clinical characteristics analysing the antibiotic prophylaxis used, septic complications seen and their management.
In this study we included 93 patients with neurosurgical disorders operated on using a stereotaxic approach in the Neurosurgical Department of the Centro Internacional de Restauración Neurologica (Cuba) during 1997 and 1998, in which antibiotic prophylaxis was used and septic patients detected. The variables studied included age, sex, neurological disorders, surgical operations done and the antibiotic used for prophylaxis. We analysed the test of clinical criteria for sepsis in all patients.
We found that a greater number of patients operated on had had functional surgery, which showed its importance as an alternative surgical method in Parkinson's disease. There was satisfactory use of antibiotic prophylaxis with a reduction in the rate of nosocomial infection; most infections were seen in the lower respiratory tract.
These results support the hypothesis of use of antibiotic prophylaxis in stereotaxic surgery to achieve a reduction in intra-hospital infections in surgical patients.
立体定向手术正变得越来越重要,因为它有可能以较低风险接近脑深部区域。它在脑肿瘤手术和帕金森病的功能手术中日常使用。神经外科手术中抗生素预防的使用存在争议,尽管在包括我们中心在内的许多中心,所有患者都接受抗生素预防。
通过分析所使用的抗生素预防措施、观察到的败血症并发症及其处理方法,研究术前临床特征。
本研究纳入了1997年和1998年在古巴国际神经恢复中心神经外科采用立体定向方法进行手术的93例神经外科疾病患者,这些患者使用了抗生素预防措施并检测出败血症患者。研究的变量包括年龄、性别、神经系统疾病、所进行的外科手术以及用于预防的抗生素。我们分析了所有患者的败血症临床标准检测。
我们发现接受手术的患者中进行功能手术的人数更多,这表明其作为帕金森病替代手术方法的重要性。抗生素预防措施使用得当,医院感染率降低;大多数感染发生在下呼吸道。
这些结果支持在立体定向手术中使用抗生素预防措施以降低手术患者院内感染的假设。