胃内镜黏膜下剥离术后和内镜黏膜下挖除术后未穿孔发热患者使用抗生素可能是不必要的：倾向评分匹配分析。
Antibiotics for fever in patients without perforation after gastric endoscopic submucosal dissection and endoscopic submucosal excavation may be unnecessary: a propensity score-matching analysis.
机构信息
Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, 17 Yongwaizheng, Street, Nanchang, 330006, Jiangxi Province, China.
出版信息
BMC Gastroenterol. 2021 Feb 12;21(1):64. doi: 10.1186/s12876-021-01602-1.
BACKGROUND
Endoscopic submucosal dissection (ESD) and endoscopic submucosal excavation (ESE) have been widely used and have gradually become the main endoscopic treatment for gastrointestinal mucosal and submucosal lesions. Whether antibiotics are necessary for fever after gastric ESD and ESE remain unclear. The aim of this study was to analyse the value of using antibiotics in patients without perforation after ESD or ESE with fever.
METHODS
In this retrospective study, patients with fever without perforation after ESD or ESE from January 2014 to January 2019 were included and divided into 2 groups: the antibiotic group and the non-antibiotic group. Fever and hospitalization time were compared between the 2 groups after propensity score matching.
RESULTS
Overall, 253 patients meeting the inclusion criteria were enrolled in the present study, with 186 patients in the non-antibiotic group and 67 patients in the antibiotic group before matching, 55 patients in the non-antibiotic group and 55 patients in the antibiotic group after matching with all baseline characteristics balanced (p > 0.05). The duration of fever was not significantly different between the 2 groups (p = 0.12). However, the median hospitalization stay in the antibiotic group was longer than that in the non-antibiotic group (8 vs 7, p = 0.007).
CONCLUSIONS
Antibiotics may be unnecessary for fever in patients without perforation and without serious co-morbidities after gastric ESD or ESE.
背景
内镜黏膜下剥离术（ESD）和内镜黏膜下挖除术（ESE）已被广泛应用，逐渐成为胃肠道黏膜及黏膜下病变的主要内镜治疗方法。对于胃 ESD 和 ESE 后发热是否需要使用抗生素仍不清楚。本研究旨在分析 ESD 或 ESE 后无穿孔发热患者使用抗生素的价值。
方法
本回顾性研究纳入了 2014 年 1 月至 2019 年 1 月 ESD 或 ESE 后无穿孔发热的患者，并分为两组：抗生素组和非抗生素组。采用倾向性评分匹配比较两组患者发热和住院时间。
结果
本研究共纳入 253 例符合纳入标准的患者，匹配前非抗生素组 186 例，抗生素组 67 例；匹配后非抗生素组 55 例，抗生素组 55 例，所有基线特征均均衡（p>0.05）。两组发热持续时间无显著差异（p=0.12）。然而，抗生素组的中位住院时间长于非抗生素组（8 天比 7 天，p=0.007）。
结论
对于胃 ESD 或 ESE 后无穿孔且无严重合并症的发热患者，抗生素可能不是必需的。
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