Hares M M, Hegarty M A, Warlow J, Malins D, Youngs D, Bentley S, Burdon D W, Keighley M R
Br J Surg. 1981 Apr;68(4):276-80. doi: 10.1002/bjs.1800680417.
A prospective randomized controlled trial has compared single dose systemic cefuroxime (n = 27) or intra-incisional cefuroxime (n = 26) with a control group (n = 28) in 81 patients undergoing gastric resection, revision gastric surgery or operation for gastro-oesophageal malignancy. In the controls the incidence of sepsis was: 35 per cent wound infection, 29 per cent abscess, 21 per cent septicaemia. After intra-incisional cefuroxime the incidence was: 4 per cent wound sepsis, 19 per cent abscess and 4 per cent septicaemia. After systemic cefuroxime only 2 patients developed wound sepsis (7 per cent) with no cases of abscess or septicaemia. Excluded from this high risk group were 36 patients who had a vagotomy with or without drainage during the trial where antibiotics were not given, 4 of whom developed wound sepsis only (11 per cent). There was a poor correlation between the individual species isolated from the gastric aspirate and the organisms responsible for postoperative infection in the controls, but there was a good correlation between fasting gastric pH and the risk of sepsis in the controls.
一项前瞻性随机对照试验，在81例接受胃切除术、胃手术翻修或胃食管恶性肿瘤手术的患者中，将单剂量全身应用头孢呋辛（n = 27）或切口内应用头孢呋辛（n = 26）与对照组（n = 28）进行了比较。对照组中败血症的发生率为：伤口感染35%，脓肿29%，败血症21%。切口内应用头孢呋辛后，发生率为：伤口败血症4%，脓肿19%，败血症4%。全身应用头孢呋辛后，仅2例患者发生伤口败血症（7%），无脓肿或败血症病例。该高危组排除了36例在试验期间行迷走神经切断术（伴或不伴引流）且未使用抗生素的患者，其中4例仅发生伤口败血症（11%）。从胃抽吸物中分离出的单个菌种与对照组术后感染的病原菌之间相关性较差，但对照组中空腹胃pH值与败血症风险之间存在良好相关性。
