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菲律宾一家政府医院中,接受抗生素治疗与未接受抗生素治疗的患者经颈甲状腺切除术后手术部位感染的发生率。

Incidence of Surgical Site Infections after Transcervical Thyroidectomy in Patients Given Antibiotics versus those without Antibiotics in a Government Hospital in the Philippines.

作者信息

Cabungcal Arsenio Claro A, Arbizo Jeric L, Hilvano-Cabungcal Ana Melissa F

机构信息

Department of Otolaryngology, Head and Neck Surgery, College of Medicine and Philippine General Hospital, University of the Philippines Manila.

Division of Urology, Department of Surgery, College of Medicine and Philippine General Hospital, University of the Philippines Manila.

出版信息

Acta Med Philipp. 2024 Apr 15;58(6):24-29. doi: 10.47895/amp.vi0.7534. eCollection 2024.

Abstract

BACKGROUND AND OBJECTIVES

Surgical site infection (SSI) makes up the largest single group of postoperative infective complications. For surgeries classified as clean surgeries of the head and neck, such as a thyroidectomy, the routine administration of antimicrobial prophylaxis is not recommended. Despite this, extended usage of antibiotics is common in developing countries. This study evaluated the need for antibiotics in elective transcervical thyroidectomy for the prevention of SSI in a tertiary government hospital in a developing country.

METHODS

This is a retrospective cohort study that included patients who have undergone elective transcervical thyroidectomy at the Department of Otolaryngology - Head and Neck Surgery (ORL-HNS) of the University of the Philippines - Philippine General (UP-PGH) Hospital from August 1, 2020 to June 30, 2022. Data collection was conducted through review of both in-patient and out-patient records.

RESULTS

The data of 58 patients were analyzed. The mean (±SD) age was 42.5±14.5 years, with approximately 2:27 male to female ratio. Of the 58 patients, 26 were given postoperative antibiotics while 32 did not receive postoperative antibiotics. None of the 58 were noted to have SSI on the 3rd postoperative day. Only 54 patients completed the 7-day follow-up of the study and their data were further analyzed. One patient had SSI. There was no significant difference between the presence and absence of postoperative antibiotics in relation to SSI (p-value>0.05).

CONCLUSION

This study shows that in patients undergoing transcervical thyroidectomies, there is no significant difference in the occurrence of SSI among patients who received and did not receive postoperative antibiotics. Therefore, there is no need to administer postoperative antibiotics, as long as a sterile surgical technique is ensured.

摘要

背景与目的

手术部位感染(SSI)是术后感染性并发症中最大的单一类别。对于诸如甲状腺切除术等被归类为头颈部清洁手术的手术,不建议常规使用抗菌药物预防。尽管如此,在发展中国家,抗生素的过度使用很常见。本研究评估了在一个发展中国家的三级政府医院中,择期经颈甲状腺切除术中预防SSI使用抗生素的必要性。

方法

这是一项回顾性队列研究,纳入了2020年8月1日至2022年6月30日在菲律宾大学 - 菲律宾总医院耳鼻喉科 - 头颈外科(ORL - HNS)接受择期经颈甲状腺切除术的患者。通过查阅住院和门诊记录进行数据收集。

结果

分析了58例患者的数据。平均(±标准差)年龄为42.5±14.5岁,男女比例约为2:27。在这58例患者中,26例术后使用了抗生素,32例未接受术后抗生素治疗。术后第3天,58例患者均未发现有SSI。只有54例患者完成了为期7天的研究随访,并对他们的数据进行了进一步分析。1例患者发生了SSI。术后使用抗生素与否与SSI之间无显著差异(p值>0.05)。

结论

本研究表明,在接受经颈甲状腺切除术的患者中,接受和未接受术后抗生素治疗的患者发生SSI的情况无显著差异。因此,只要确保无菌手术技术,就无需使用术后抗生素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2d49/11151127/5edf5a122b6e/AMP-58-6-7534-g001.jpg

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