Jang Ho Sung, Choi Kyung Hwa, Yang Seung Choul, Han Woong Kyu
Department of Urology, Urological Science Institute, Yonsei University Health System, Seoul, Korea.
Korean J Urol. 2011 Feb;52(2):115-8. doi: 10.4111/kju.2011.52.2.115. Epub 2011 Feb 21.
To perform a prospective analysis of the clinical outcomes of prophylactic antibiotic treatment before the standard surgical modality of living donor nephrectomy (LDN) without postoperative antibiotic treatment.
From November 2005 to June 2010, a total of 470 patients underwent LDN at our medical institution, and 280 of these patients were injected with 1 g cephalosporin 30 minutes before the operation. The group receiving prophylactic antibiotics was compared with a control group composed of 190 patients who received injections of 2 g cephalosporin per day for 5 days after the operation. The presence of fever, incidence of blood transfusion, and period of drainage use were compared between the two groups.
There were no significant differences in gender, age, body mass index, incidence of blood transfusion after the operation, fever over 38℃ 3 days after the operation, or period of drain insertion between the single-dose group and the control group. The follow-up was conducted for 1 month after the operation, and 1 case of surgical site infection (SSI) was observed in each group (p=0.783).
Of 280 patients in the single-dose group, 1 contracted SSI. In comparison with the control group, which was dosed with prophylactic antibiotics for 5 days after the operation, the single-dose group did not have a significantly different occurrence of SSI. We found that the incidence rate of SSI did not increase, even though prophylactic antibiotics were not used after standard and conventional open surgeries, such as video-assisted minilaparotomy surgery.
对活体供肾肾切除术(LDN)标准手术方式且术后不使用抗生素治疗的情况下预防性抗生素治疗的临床结果进行前瞻性分析。
2005年11月至2010年6月,共有470例患者在我院接受了LDN手术,其中280例患者在手术前30分钟注射了1克头孢菌素。将接受预防性抗生素治疗的组与由190例患者组成的对照组进行比较,对照组患者在术后每天注射2克头孢菌素,共5天。比较两组患者发热情况、输血发生率及引流使用时间。
单剂量组与对照组在性别、年龄、体重指数、术后输血发生率、术后3天体温超过38℃情况或引流管留置时间方面均无显著差异。术后进行了1个月的随访,每组均观察到1例手术部位感染(SSI)(p = 0.783)。
单剂量组的280例患者中有1例发生了SSI。与术后使用预防性抗生素5天的对照组相比,单剂量组SSI的发生率没有显著差异。我们发现,即使在标准和传统开放手术(如电视辅助小切口手术)后不使用预防性抗生素,SSI的发生率也没有增加。