持续输注与间歇输注头孢唑林预防非体外循环冠状动脉旁路移植术后感染的效果比较
Comparison of the Effectiveness of Continuous versus Intermittent Cefazolin for the Prevention of Infection after Off-Pump Coronary Artery Bypass Graft.
作者信息
Forouzannia Seyed Khalil, Karimi-Bondarabadi Ali Akbar, Bagherinasab Mostafa, Sarebanhassanabadi Mohammadtaghi
机构信息
Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Yazd Cardiovascular Research Center, Afshar Hospital, Shahid Sadoughi University of Medical Sciences, Yazd, Iran. ; Student Research Committee, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
出版信息
J Tehran Heart Cent. 2014;9(3):120-3. Epub 2014 Jul 3.
BACKGROUND
Surgical site infection is known as a common complication after cardiac surgery, and Cefazolin is the best prophylactic antibiotic to prevent this complication. The goal of this study was to evaluate the effect of continuous and intermittent Cefazolin for the prevention of superficial surgical site infection following off-pump coronary artery bypass (OPCAB).
METHODS
This prospective randomized clinical trial study was conducted on 141 patients candidated for OPCAB and divided into two groups. This study was performed between February 2011 and February 2012 in the Iranian city of Yazd. Patients in both groups received 2 g of Cefazolin as a starting dose and at 30 minutes before incision. Definition of surgical site infections was according to the Centers for Disease Control and Prevention Criteria (CDC-criteria). In the continuous infusion group (n = 74), 3 g of Cefazolin was infused over a 24-hour period after surgery. In the intermittent group (n = 67), 1 g of Cefazolin was administered at 3, 11, and 19 hours after the starting dose. Hyperlipidemia, diabetes, hypertension, smoking, history of heart disease, and incidences of superficial infection were compared between the two groups. Duration of follow- up was 4 weeks.
RESULTS
The mean age of the patients was 60.49 ± 10.63 years. The patients were 30.5% female and 69.5% male. There were no significant differences in age, body surface area, duration of operation, number of distal grafts, number of proximal grafts, and duration of hospital stay before heart surgery between two groups. The incidence of infection in intermittent group was (7.5%) and in continuous groups was (2.7%). There was no significant difference in the incidence of infection between the two groups (p value = 0.26).
CONCLUSION
Our findings in this study showed no significant differences between continuous and intermittent Cefazolin for the prevention of superficial surgical site infections after OPCAB.
背景
手术部位感染是心脏手术后常见的并发症，头孢唑林是预防该并发症的最佳预防性抗生素。本研究的目的是评估持续和间歇性使用头孢唑林预防非体外循环冠状动脉搭桥术（OPCAB）后浅表手术部位感染的效果。
方法
本前瞻性随机临床试验研究对141例拟行OPCAB的患者进行，分为两组。本研究于2011年2月至2012年2月在伊朗亚兹德市进行。两组患者均接受2g头孢唑林作为起始剂量，并在切口前30分钟给药。手术部位感染的定义依据疾病控制与预防中心标准（CDC标准）。在持续输注组（n = 74）中，术后24小时内输注3g头孢唑林。在间歇组（n = 67）中，起始剂量后3、11和19小时各给予1g头孢唑林。比较两组患者的高脂血症、糖尿病、高血压、吸烟、心脏病史及浅表感染发生率。随访时间为4周。
结果
患者的平均年龄为60.49±10.63岁。患者中女性占30.5%，男性占69.5%。两组患者在年龄、体表面积、手术时间、远端移植物数量、近端移植物数量及心脏手术前住院时间方面无显著差异。间歇组感染发生率为（7.5%），持续组为（2.7%）。两组感染发生率无显著差异（p值 = 0.26）。
结论
我们在本研究中的发现表明，持续和间歇性使用头孢唑林预防OPCAB后浅表手术部位感染无显著差异。
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