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针刺后感染不良事件:临床进展和微生物病因学。

Infectious Adverse Events Following Acupuncture: Clinical Progress and Microbiological Etiology.

机构信息

Department of Emergency Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Department of Infectious Diseases, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

出版信息

J Korean Med Sci. 2018 May 9;33(24):e164. doi: 10.3346/jkms.2018.33.e164. eCollection 2018 Jun 11.

Abstract

BACKGROUND

We investigated the clinical progress and bacteriological characteristics of infectious adverse events (AEs) following acupuncture and compared patient characteristics between serious and non-serious outcome groups.

METHODS

A retrospective observational study was conducted in 1,174 patients with infectious complications associated with acupuncture at the emergency department (ED) in a tertiary hospital in Korea between 2010 and 2014. Serious outcome was defined as development of septic shock, admission to intensive care unit (ICU) or attaining permanent morbidity.

RESULTS

Forty-eight patients had certain causality and cellulitis, necrotizing fasciitis and osteomyelitis were common in order. Among them, 9 patients (18.8%) were categorized into serious outcome group, and they showed devastating outcomes such as septic shock (n = 2), ICU admission (n = 4), and permanent sequelae (n = 5). The serious group had delayed admission to the ED after acupuncture (30.0 [4.0-55.0] vs. 3.0 [1.0-10.0] days, = 0.023). Methicillin-sensitive was the most frequently identified microorganism. The patients in the serious group required longer treatment duration (139.0 [49.0-183.5] vs. 14.0 [7.0-34.0] days, < 0.001) as well as more operation with local (44.4% vs. 10.3%, = 0.031) or general anaesthesia (33.3% vs. 2.6%, = 0.017).

CONCLUSION

The infectious AEs after acupuncture may cause serious outcomes. Patients and primary physicians should be aware of the risk of infectious complications and make efforts to prevent them.

摘要

背景

本研究旨在调查针灸治疗后感染不良事件(AE)的临床进展和细菌学特征,并比较严重和非严重结局患者的特征。

方法

本研究为回顾性观察研究,纳入 2010 年至 2014 年期间在韩国一家三级医院急诊科因针灸感染并发症就诊的 1174 例患者。严重结局定义为脓毒症休克、入住重症监护病房(ICU)或出现永久性残疾。

结果

48 例患者具有明确的因果关系,蜂窝织炎、坏死性筋膜炎和骨髓炎是最常见的类型。其中,9 例(18.8%)患者归入严重结局组,表现为脓毒症休克(n=2)、入住 ICU(n=4)和永久性后遗症(n=5)等严重后果。严重组患者在针灸后就诊至急诊科的时间延迟(30.0[4.0-55.0]天 vs. 3.0[1.0-10.0]天, = 0.023)。最常鉴定出的微生物是耐甲氧西林的 。严重组患者的治疗时间更长(139.0[49.0-183.5]天 vs. 14.0[7.0-34.0]天, < 0.001),需要更多的局部(44.4% vs. 10.3%, = 0.031)或全身麻醉(33.3% vs. 2.6%, = 0.017)手术。

结论

针灸后感染性 AE 可能导致严重结局。患者和初级医师应意识到感染并发症的风险,并努力预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2c6e/5990445/17edde0e7b08/jkms-33-e164-g001.jpg

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