Löhde E, Scholz L, Gemperle A, Langmark H, Hopfenmüller W, Abri O, Kraas E
Institut für Krankenhaushygiene und Mikrobiologie, 1. Chirurgische Abteilung des Krankenhauses Moabit, Berlin.
Zentralbl Chir. 1992;117(6):325-30.
The prophylactic effect of intraoperative "one shot" antibiotic application in colorectal surgery was investigated. Patients were randomised and the antibiotic combination Mezlocillin/Metronidazole (group A) or Amoxicillin/Clavulamid acid (group B) was applicated in 160 patients. 111 patients were selected for the study (group A: 59; group B: 52 patients). In the postoperative course 53% (group A) and 67% (group B) of the patients developed bacterial infections. Abdominal wound healing was complicated by infection in 15% (A) and 12% (B) of the patients. A significant difference between the two groups could not be proven, 24% of all patients with documented intraoperative bacterial contamination and 10% of the patients with negative findings developed wound infections. In colorectal surgery patients are still at high risk for infectious complications. Applicated antibiotics should basically cover aerobic and anaerobic germs.
研究了术中“一次性”应用抗生素在结直肠手术中的预防效果。患者被随机分组,160例患者应用了抗生素组合美洛西林/甲硝唑(A组)或阿莫西林/克拉维酸(B组)。选取111例患者进行研究(A组:59例;B组:52例)。术后过程中,53%(A组)和67%(B组)的患者发生了细菌感染。腹部伤口愈合因感染而复杂化的患者在A组为15%,在B组为12%。两组之间未证实存在显著差异,所有术中记录有细菌污染的患者中有24%以及检查结果为阴性的患者中有10%发生了伤口感染。在结直肠手术中,患者发生感染性并发症的风险仍然很高。应用的抗生素基本上应覆盖需氧菌和厌氧菌。