肝切除术后抗生素预防的评价：一项随机对照试验。

Evaluation of postoperative antibiotic prophylaxis after liver resection: a randomized controlled trial.

机构信息

Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan.

出版信息

Am J Surg. 2013 Jul;206(1):8-15. doi: 10.1016/j.amjsurg.2012.08.016. Epub 2013 May 22.

DOI:10.1016/j.amjsurg.2012.08.016

PMID:23706259

Abstract

BACKGROUND

Antibiotic prophylaxis is frequently administered after liver resection to prevent postoperative infections. However, very few studies have examined the usefulness of antibiotic prophylaxis after liver resection. A randomized controlled trial was conducted to evaluate the postoperative antibiotic prophylaxis in patients after liver resection.

METHODS

A total of 241 patients scheduled to undergo liver resection were randomly assigned to the non-postoperative antibiotic group (n = 95) or the antibiotic group (n = 95). The antibiotic group was given flomoxef sodium every 12 hours for 3 days after the operation. The end point was signs of infection, surgical site infection, or infectious complications.

RESULTS

There were no significant differences between the 2 groups in signs of infection (21.3% vs 25.5%, P = .606), the incidence of systemic inflammatory response syndrome (11.7% vs 17.0%, P = .406), infectious complications (7.5% vs 17.0%, P = .073), surgical site infection (10.6% vs 13.8%, P = .657), and remote site infection (2.1% vs 8.5%, P = .100).

CONCLUSIONS

Postoperative antibiotic prophylaxis cannot prevent postoperative infections after liver resection, and it is thought that antibiotic prophylaxis is unnecessary and costly.

摘要

背景

肝切除术后常给予抗生素预防以预防术后感染。然而，很少有研究探讨肝切除术后抗生素预防的效果。本研究旨在评估肝切除术后患者的术后抗生素预防。

方法

241 例行肝切除术的患者随机分为非术后抗生素组（n=95）和抗生素组（n=95）。术后抗生素组给予头孢唑肟钠，每 12 小时 1 次，连用 3 天。主要终点为感染迹象、手术部位感染或感染性并发症。

结果

两组在感染迹象（21.3% vs 25.5%，P=.606）、全身炎症反应综合征（11.7% vs 17.0%，P=.406）、感染性并发症（7.5% vs 17.0%，P=0.073）、手术部位感染（10.6% vs 13.8%，P=0.657）和远处部位感染（2.1% vs 8.5%，P=0.100）方面无显著差异。