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缩短预防性抗生素使用时间对结直肠癌手术后手术部位感染发生率的影响。

Influence of Shorter Duration of Prophylactic Antibiotic Use on the Incidence of Surgical Site Infection Following Colorectal Cancer Surgery.

作者信息

Park Youn Young, Kim Chang Woo, Park Sun Jin, Lee Kil Yeon, Lee Jung Joo, Lee Hye Ok, Lee Suk-Hwan

机构信息

Department of Surgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.

Department of Surgery, Kyung Hee University Medical Center, Kyung Hee University School of Medicine, Seoul, Korea.

出版信息

Ann Coloproctol. 2015 Dec;31(6):235-42. doi: 10.3393/ac.2015.31.6.235. Epub 2015 Dec 31.

Abstract

PURPOSE

This study aimed to identify the risk factors for surgical site infections (SSIs) in patients undergoing colorectal cancer surgery and to determine whether significantly different SSI rates existed between the short prophylactic antibiotic use group (within 24 hours) and the long prophylactic antibiotic use group (beyond 24 hours).

METHODS

The medical records of 327 patients who underwent colorectal resection due to colorectal cancer from January 2010 to May 2014 at a single center were retrospectively reviewed, and their characteristics as well as the surgical factors known to be risk factors for SSIs, were identified.

RESULTS

Among the 327 patients, 45 patients (13.8%) developed SSIs. The patients were divided into two groups according to the duration of antibiotic use: group S (within 24 hours) and group L (beyond 24 hours). Of the 327 patients, 114 (34.9%) were in group S, and 213 (65.1%) were in group L. Twelve patients (10.5%) in group S developed SSIs while 33 patients (15.5%) in group L developed SSIs (P = 0.242). History of diabetes mellitus and lung disease, long operation time, and perioperative transfusion were independent risk factors for SSIs.

CONCLUSION

This study shows that discontinuation of prophylactic antibiotics within 24 hours after colorectal surgery has no significant influence on the incidence of SSIs. This study also showed that history of diabetes mellitus and lung disease, long operation time, and perioperative transfusion were associated with increased SSI rates.

摘要

目的

本研究旨在确定接受结直肠癌手术患者手术部位感染(SSIs)的风险因素,并确定短期预防性抗生素使用组(24小时内)和长期预防性抗生素使用组(超过24小时)之间的SSIs发生率是否存在显著差异。

方法

回顾性分析了2010年1月至2014年5月在单一中心因结直肠癌接受结直肠切除术的327例患者的病历,确定了他们的特征以及已知为SSIs风险因素的手术因素。

结果

327例患者中,45例(13.8%)发生了SSIs。根据抗生素使用时间将患者分为两组:S组(24小时内)和L组(超过24小时)。327例患者中,114例(34.9%)在S组,213例(65.1%)在L组。S组12例患者(10.5%)发生了SSIs,而L组33例患者(15.5%)发生了SSIs(P = 0.242)。糖尿病和肺部疾病史、手术时间长以及围手术期输血是SSIs的独立风险因素。

结论

本研究表明,结直肠手术后24小时内停用预防性抗生素对SSIs的发生率没有显著影响。本研究还表明,糖尿病和肺部疾病史、手术时间长以及围手术期输血与SSIs发生率增加有关。

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Efforts to Prevent Surgical Site Infection After Colorectal Surgery.结直肠手术后预防手术部位感染的措施
Ann Coloproctol. 2015 Dec;31(6):211-2. doi: 10.3393/ac.2015.31.6.211. Epub 2015 Dec 31.

本文引用的文献

1
Antimicrobial prophylaxis for colorectal surgery.结直肠手术的抗菌预防
Cochrane Database Syst Rev. 2014 May 9;2014(5):CD001181. doi: 10.1002/14651858.CD001181.pub4.
5
Clinical practice guidelines for antimicrobial prophylaxis in surgery.手术抗菌预防临床实践指南
Am J Health Syst Pharm. 2013 Feb 1;70(3):195-283. doi: 10.2146/ajhp120568.
9
Antimicrobial prophylaxis for colorectal surgery.结直肠手术的抗菌预防
Cochrane Database Syst Rev. 2009 Jan 21(1):CD001181. doi: 10.1002/14651858.CD001181.pub3.

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