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结直肠癌手术后的抗生素预防与手术切口部位感染:330例病例分析

Antibiotic prophylaxis and incisional surgical site infection following colorectal cancer surgery: an analysis of 330 cases.

作者信息

Lohsiriwat Varut, Lohsiriwat Darin

机构信息

Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 2009 Jan;92(1):12-6.

Abstract

OBJECTIVE

To evaluate the rate of incisional surgical site infection (SSI) following colorectal cancer surgery in a university hospital and to determine whether duration of prophylactic antibiotic administration can affect the development of this complication.

MATERIAL AND METHOD

The medical records of 330 patients with colorectal cancer undergoing elective oncological resection between 2003 and 2006 at Siriraj Hospital were reviewed. Patients were divided into two groups according to the duration of antibiotic administration; group A: prophylactic antibiotics were discontinued within 24 hours after surgery and group B: antibiotics administration was extended beyond 24 hours after surgery. Data including rate of incisional SSI were analyzed.

RESULTS

There were 180 males and 150 females, with a mean age of 63 years. There were 126 patients (38%) in group A and 204 patients (62%) in group B. There was no statistical difference in patient characteristics and tumor-related variables between the two groups, except tumor location. Overall rate of incisional SSI was 14.5%. The rate of incisional SSI was not statistically different between the two groups (group A 11.1% vs. group B 16.7%, p = 0.22). Patients with incisional SSI had a significantly longer hospital stay than patients without incisional SSI (15.9 vs. 8.3 days, p < 0.001).

CONCLUSION

This present study found the overall rate of incisional SSI following colorectal surgery to be 14.5%. There was no significant difference in the rate of this complication between the two groups. Thus, surgeons should be encouraged to use a shorter duration of antibiotics to prevent the emergence of antibiotic-resistant bacterial infection and reduce hospital expenditure.

摘要

目的

评估某大学医院结直肠癌手术后手术切口部位感染(SSI)的发生率,并确定预防性抗生素使用时间是否会影响该并发症的发生。

材料与方法

回顾了2003年至2006年在诗里拉吉医院接受择期肿瘤切除术的330例结直肠癌患者的病历。根据抗生素使用时间将患者分为两组;A组:术后24小时内停用预防性抗生素;B组:术后抗生素使用时间延长至24小时以上。分析包括手术切口SSI发生率在内的数据。

结果

男性180例,女性150例,平均年龄63岁。A组126例患者(38%),B组204例患者(62%)。除肿瘤位置外,两组患者的特征和肿瘤相关变量无统计学差异。手术切口SSI的总体发生率为14.5%。两组手术切口SSI发生率无统计学差异(A组11.1% vs. B组16.7%,p = 0.22)。有手术切口SSI的患者住院时间明显长于无手术切口SSI的患者(15.9天 vs. 8.3天,p < 0.001)。

结论

本研究发现结直肠癌手术后手术切口SSI的总体发生率为14.5%。两组该并发症的发生率无显著差异。因此,应鼓励外科医生使用更短时间的抗生素,以预防耐药细菌感染的出现并减少医院支出。

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