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两种抗生素预防方案在口腔颌面创伤手术中的疗效评估:初步结果

Efficacy assessment of two antibiotic prophylaxis regimens in oral and maxillofacial trauma surgery: preliminary results.

作者信息

Campos Giordano Bp, Lucena Eudes Es, da Silva José Sandro P, Gomes Petrus P, Germano Adriano R

机构信息

Dentistry, Federal University of Rio Grande do Norte Natal, Rio Grande do Norte, Brazil.

Division Morphology, Faculty of Dentistry, State University of Rio Grande do Norte Caicó, Brazil.

出版信息

Int J Clin Exp Med. 2015 Feb 15;8(2):2846-52. eCollection 2015.

Abstract

The study set out to evaluate the efficacy of two antibiotic prophylaxis regimens in patients with facial fractures admitted to the Oral and Maxillofacial Surgery and Traumatology services of the Onofre Lopes University Hospital attached to the Federal University of Rio Grande do Norte in the period from December 2011 to December 2012. The sample consisted of 74 patients divided into two groups, GI with forty-three patients and GII with 32. Both groups received 2 g of cefazolin, 20 minutes before surgery. The postoperative protocol for each group was randomly determined; group I (single dose) received no antibiotics after surgery but group II (24 h dosage) received 1 g of cefazolin every 6 hours for 24 hours. Postoperative infection incidence was 9.3% (seven patients), six patients in Group I and one in Group II. 85% of the infections were in mandibular fractures. Results were presented qualitatively and quantitatively and the Chi square test (taking the value for p to be < 0.05) showed no statistically significant differences in the efficacies of the two regimens in the comparisons made between the cases of fractures in the upper and middle thirds of the face with those in the lower third (mandibular fractures). Considering mandibular fractures alone, Group II proved to be more efficacious with a p value of 0.02. However, to confirm the tendency shown in the mandibular fracture treatments whereby prolonging antibiotic administration for 24 hours appeared to be beneficial, research needs to be done with much larger sample groups.

摘要

本研究旨在评估2011年12月至2012年12月期间,在隶属于北里奥格兰德联邦大学的奥诺弗雷·洛佩斯大学医院口腔颌面外科和创伤科就诊的面部骨折患者中,两种抗生素预防方案的疗效。样本包括74名患者,分为两组,第一组(GI)有43名患者,第二组(GII)有32名患者。两组均在手术前20分钟接受2克头孢唑林。每组的术后方案是随机确定的;第一组(单剂量组)术后不使用抗生素,而第二组(24小时剂量组)每6小时接受1克头孢唑林,共24小时。术后感染发生率为9.3%(7名患者),第一组6名,第二组1名。85%的感染发生在下颌骨骨折患者中。结果从定性和定量两方面呈现,卡方检验(取p值<0.05)显示,在面部上三分之一和中三分之一骨折病例与下三分之一(下颌骨骨折)病例的比较中,两种方案的疗效无统计学显著差异。仅考虑下颌骨骨折,第二组的疗效更佳,p值为0.02。然而,为了证实下颌骨骨折治疗中显示出的趋势,即延长抗生素给药24小时似乎有益,需要用更大的样本组进行研究。

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Outcomes of prophylactic antibiotics following surgery for zygomatic bone fractures.预防性抗生素在颧骨骨折手术后的应用效果。
J Craniomaxillofac Surg. 2010 Mar;38(2):131-3. doi: 10.1016/j.jcms.2009.03.015. Epub 2009 May 17.
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Infection following treatment of mandible fractures: the role of immunosuppression and polysubstance abuse.下颌骨骨折治疗后的感染:免疫抑制和多物质滥用的作用。
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Jan;103(1):38-42. doi: 10.1016/j.tripleo.2006.02.013. Epub 2006 Aug 10.

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