Gould E K, Harvey J A, Dytrych J K
Department of Gynaecology, Newcastle General Hospital, England.
Am J Obstet Gynecol. 1989 Feb;160(2):317-9. doi: 10.1016/0002-9378(89)90433-x.
According to previous studies the presence of preoperative antibodies to gram-negative lipopolysaccharides has a protective effect against postoperative infection and pyrexia in patients undergoing urologic and cardiac surgical procedures. Preoperative serum specimens collected from 86 women awaiting major gynecologic surgery were tested for the presence of antiendotoxin by a qualitative method. These patients were closely followed up in the postoperative period and any evidence of pyrexia or infection was noted. There were 21 (24%) patients who had preexisting antibodies. Of the women studied, 47 (55%) had some form of postoperative infection, of which 32 (37%) were exclusively a result of gram-negative bacteria. There was a significant association (p less than 0.05) between postoperative infection and the absence of preexisting antibodies. This association was particularly striking (p less than 0.02) when postoperative urinary tract infections were considered. There was no association between postoperative pyrexia and the absence of preexisting antibody. Our results confirm the findings of previous studies to evaluate the protective role of antiendotoxin in surgical procedures. In the future immunization may be considered an adjunct or alternative to prophylactic antibiotics.
根据以往的研究，术前存在针对革兰氏阴性菌脂多糖的抗体，对接受泌尿外科和心脏外科手术的患者术后感染和发热具有保护作用。采用定性方法对86名等待大型妇科手术的女性术前采集的血清标本进行抗内毒素检测。这些患者在术后进行密切随访，并记录发热或感染的任何迹象。有21名（24%）患者术前就存在抗体。在研究的女性中，47名（55%）发生了某种形式的术后感染，其中32名（37%）完全是由革兰氏阴性菌引起的。术后感染与术前不存在抗体之间存在显著关联（p<0.05）。当考虑术后尿路感染时，这种关联尤为显著（p<0.02）。术后发热与术前不存在抗体之间没有关联。我们的结果证实了以往研究中关于评估抗内毒素在手术过程中保护作用的发现。未来，免疫接种可能被视为预防性抗生素的辅助手段或替代方法。
