阑尾切除术期间进行常规腹腔积液培养是否合理？

Are routine peritoneal fluid cultures during appendicectomy justified?

作者信息

Khan M N, Vidya R, Lee R E

机构信息

Department of General Surgery, North Hampshire Hospital, Basingstoke, UK.

出版信息

Ir J Med Sci. 2007 Mar;176(1):37-40. doi: 10.1007/s11845-007-0003-4.

DOI:10.1007/s11845-007-0003-4

PMID:17849522

Abstract

BACKGROUND

To determine the impact of obtaining routine peritoneal fluid cultures during appendicectomy, on the treatment and the clinical outcomes.

METHODS

The case notes of 137 consecutive patients having appendicectomy, selected from the microbiology database over a period of 1 year were reviewed. The microorganisms in peritoneal cultures, selection of antibiotics and clinical outcomes were recorded. Patients were subdivided into two groups; group I: uncomplicated appendicitis and group II: complicated appendicitis.

RESULTS

The study included 137 patients with a median age of 19 years. Cultures were obtained from 79.5% of patients (group I: 67/84, group II: 42/53). Cultures were positive in 28.3% (19/67) patients in group I and 69% (29/ 42) in group II. Wound infection (5.6%), prolonged ileus (7.5%) and intra-abdominal abscess (3.7%) were the recorded complications in group II. Antibiotics were modified in 3 out of 109 patients.

CONCLUSION

Intra-operative peritoneal cultures during appendicectomy do not significantly contribute towards patient management.

摘要

背景

确定阑尾切除术期间进行常规腹腔积液培养对治疗及临床结局的影响。

方法

回顾了从微生物数据库中选取的137例连续接受阑尾切除术患者的病历，这些患者选自1年期间。记录腹腔培养中的微生物、抗生素的选择及临床结局。患者被分为两组；第一组：单纯性阑尾炎，第二组：复杂性阑尾炎。

结果

该研究纳入了137例患者，中位年龄为19岁。79.5%的患者进行了培养（第一组：67/84，第二组：42/53）。第一组28.3%（19/67）的患者培养结果为阳性，第二组为69%（29/42）。记录的第二组并发症包括伤口感染（5.6%）、肠梗阻延长（7.5%）和腹腔内脓肿（3.7%）。109例患者中有3例更改了抗生素。