Demetriades D, Breckon V, Breckon C, Kakoyiannis S, Psaras G, Lakhoo M, Charalambides D
Department of Surgery, Baragwanath Hospital, South Africa.
Ann R Coll Surg Engl. 1991 Nov;73(6):348-51.
Most prospective studies recommend antibiotic prophylaxis whilst a thoracostomy tube is in place or even longer. We conducted a randomised study of 188 patients with penetrating chest injuries requiring a chest drain. Of these patients, 95 received a single dose of ampicillin before insertion of the chest tube, the remaining 93 patients received additional antibiotic prophylaxis for as long as the drain was in place. The incidence of intrathoracic sepsis (pneumonia or empyema) was 3.1% and 3.2%, respectively. It is concluded that single-dose prophylaxis in penetrating chest trauma is as effective as prolonged prophylaxis. The importance of chest physiotherapy immediately after the drain insertion and of early removal of the drain is stressed. The role of various possible risk factors in the development of sepsis is discussed.
大多数前瞻性研究建议在留置胸腔造口管期间甚至更长时间内进行抗生素预防。我们对188例需要胸腔引流的穿透性胸部损伤患者进行了一项随机研究。在这些患者中，95例在插入胸管前接受了单剂量氨苄西林，其余93例患者在引流管留置期间接受了额外的抗生素预防。胸腔内脓毒症（肺炎或脓胸）的发生率分别为3.1%和3.2%。得出的结论是，穿透性胸部创伤的单剂量预防与延长预防一样有效。强调了引流管插入后立即进行胸部物理治疗以及早期拔除引流管的重要性。讨论了各种可能的危险因素在脓毒症发生中的作用。
