Carpentier J P, Coursange F, Mianne D, Raphnon G C, Aubert M, Barnaud P
Hôpital d'Instruction des Armées A. Lavéran, Marseille Armées.
Med Trop (Mars). 1989 Jan-Mar;49(1):47-50.
Infection is a constant concern during perioperative period. Bacteremia occur during intervention and immediate postoperative period. They are the risk of acute complications, mainly septic shock with a high mortality rate. Escherichia coli is the germ most often found, then Enterococcus and other gram-negative germs. Diagnosis of an urinary infection is made difficult because the presence of a vesical catheter; so, 10(3) bacteria per ml. have to be considered as pathological. Two therapeutic behaviours can be considered in practice: suitable antibiotherapy in obvious infections, but sterilization of urines must not delay surgical intervention, short-time peri-operative prophylaxis cephalosporins of the 2nd or 3rd generation are most often utilized. Overseas, trimethoprim associated with sulfamides can be administrated per os every 2 hours before surgical intervention, at the time of anesthesia for example.
感染是围手术期一直需要关注的问题。在手术干预期间及术后即刻会发生菌血症。它们是急性并发症的风险因素,主要是感染性休克,死亡率很高。大肠杆菌是最常发现的病菌,其次是肠球菌和其他革兰氏阴性菌。由于存在膀胱导管,尿路感染的诊断变得困难;因此,每毫升尿液中10³个细菌就必须被视为病理性的。在实际操作中可以考虑两种治疗方法:对于明显感染采用合适的抗生素治疗,但尿液消毒不能延误手术干预,最常使用的是第二代或第三代头孢菌素进行短期围手术期预防。在国外,例如在麻醉时,在手术干预前每2小时口服给予甲氧苄啶与磺胺类药物联合制剂。