术前抗生素预防不能降低择期肝切除术患者术后感染并发症的风险。
Preoperative Antibiotic Prophylaxis Does Not Reduce the Risk of Postoperative Infectious Complications in Patients Undergoing Elective Hepatectomy.
作者信息
Zhou Yan-Ming, Chen Zhen-Yi, Li Xiu-Dong, Xu Dong-Hui, Su Xu, Li Bin
机构信息
Department of Hepatobiliary and Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen, China.
出版信息
Dig Dis Sci. 2016 Jun;61(6):1707-13. doi: 10.1007/s10620-015-4008-y. Epub 2015 Dec 29.
BACKGROUND AND AIM
Postoperative infection is not uncommon after hepatectomy. This study assessed the effectiveness of preoperative antibiotic prophylaxis in elective hepatectomy in a randomized clinical trial setting.
METHODS
A total of 120 patients who were scheduled to undergo elective hepatectomy were equally randomized to receive either intravenous cefuroxime 1.5 g (group A) or placebo (group B) within 30 min prior to skin incision.
RESULTS
Overall, postoperative infection occurred in 26 (21.6 %) of the 120 patients. There was no statistically significant difference between groups A and B in the incidence of overall infection (23.3 vs. 20.0 %, P = 0.658), surgical site infection (13.3 vs. 15 %, P = 0.793), and remote site infection (13.3 vs. 11.7 %, P = 0.783).
CONCLUSION
The use of preoperative antibiotic prophylaxis as a routine practice in patients undergoing elective hepatectomy is unnecessary because it does not reduce the risk of postoperative infectious complications.
背景与目的
肝切除术后感染并不罕见。本研究在随机临床试验环境中评估了择期肝切除术前抗生素预防的有效性。
方法
总共120例计划接受择期肝切除的患者被平均随机分为两组，在皮肤切开前30分钟内，一组接受静脉注射1.5克头孢呋辛（A组），另一组接受安慰剂（B组）。
结果
总体而言，120例患者中有26例（21.6%）发生了术后感染。A组和B组在总体感染发生率（23.3%对20.0%，P = 0.658）、手术部位感染发生率（13.3%对15%，P = 0.793）和远处部位感染发生率（13.3%对11.7%，P = 0.783）方面无统计学显著差异。
结论
在择期肝切除患者中常规使用术前抗生素预防是不必要的，因为它不会降低术后感染并发症的风险。
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