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腹部孤立性创伤患者初始抗生素治疗现状及感染分析:韩国一项多中心试验

Current status of initial antibiotic therapy and analysis of infections in patients with solitary abdominal trauma: a multicenter trial in Korea.

作者信息

Lee Gil Jae, Kyoung Kyu-Hyouck, Kim Ki Hoon, Kim Namryeol, Sul Young Hoon, Lim Kyoung Hoon, Hong Suk-Kyung, Cho Hangjoo

机构信息

Department of Traumatology, Gachon University Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.

Department of Surgery and Trauma Center, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea.

出版信息

Ann Surg Treat Res. 2021 Feb;100(2):119-125. doi: 10.4174/astr.2021.100.2.119. Epub 2021 Feb 1.

Abstract

PURPOSE

Proper use of antibiotics during emergency abdominal surgery is essential in reducing the incidence of surgical site infection. However, no studies have investigated the type of antibiotics and duration of therapy in individuals with abdominal trauma in Korea. We aimed to investigate the status of initial antibiotic therapy in patients with solitary abdominal trauma.

METHODS

From January 2015 to December 2015, we retrospectively analyzed the medical records of patients with solitary abdominal trauma from 17 institutions including regional trauma centers in South Korea. Both blunt and penetrating abdominal injuries were included. Time from arrival to initial antibiotic therapy, rate of antibiotic use upon injury mechanism, injured organ, type, and duration of antibiotic use, and postoperative infection were investigated.

RESULTS

Data of the 311 patients were collected. The use of antibiotic was initiated in 96.4% of patients with penetrating injury and 79.7% with blunt injury. Initial antibiotics therapy was provided to 78.2% of patients with solid organ injury and 97.5% with hollow viscus injury. The mean day of using antibiotics was 6 days in solid organ injuries, 6.2 days in hollow viscus. Infection within 2 weeks of admission occurred in 36 cases. Infection was related to injury severity (Abbreviated Injury Scale of >3), hollow viscus injury, operation, open abdomen, colon perforation, and RBC transfusion. There was no infection in cases with laparoscopic operation. Duration of antibiotics did not affect the infection rate.

CONCLUSION

Antibiotics are used extensively (84.2%) and for long duration (6.2 days) in patients with abdominal injury in Korea.

摘要

目的

在急诊腹部手术中合理使用抗生素对于降低手术部位感染的发生率至关重要。然而,韩国尚无研究调查腹部创伤患者使用的抗生素类型及治疗持续时间。我们旨在调查单纯腹部创伤患者初始抗生素治疗的情况。

方法

回顾性分析2015年1月至2015年12月期间韩国17家机构(包括地区创伤中心)收治的单纯腹部创伤患者的病历。纳入钝性和穿透性腹部损伤患者。调查从入院到开始初始抗生素治疗的时间、根据损伤机制的抗生素使用率、受伤器官、抗生素使用类型和持续时间以及术后感染情况。

结果

收集了311例患者的数据。穿透伤患者中96.4%使用了抗生素,钝性伤患者中79.7%使用了抗生素。实体器官损伤患者中78.2%接受了初始抗生素治疗,中空脏器损伤患者中97.5%接受了初始抗生素治疗。实体器官损伤患者使用抗生素的平均天数为6天,中空脏器损伤患者为6.2天。入院后2周内发生感染的有36例。感染与损伤严重程度(简明损伤定级>3)、中空脏器损伤、手术、开放性腹部、结肠穿孔和红细胞输血有关。腹腔镜手术患者未发生感染。抗生素使用持续时间未影响感染率。

结论

在韩国,腹部损伤患者广泛(84.2%)且长时间(6.2天)使用抗生素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f296/7870430/272b06368d75/astr-100-119-g001.jpg

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