南方医科大学学报
南方醫科大學學報
남방의과대학학보
JOURNAL OF SOUTHERN MEDICAL UNIVERSITY
2015年
4期
578-582
,共5页
谢年谨%罗淞元%薛凌%李威%谷梦楠%刘媛%黄文晖%范瑞新%陈纪言%罗建方%LUO Jianfang
謝年謹%囉淞元%薛凌%李威%穀夢楠%劉媛%黃文暉%範瑞新%陳紀言%囉建方%LUO Jianfang
사년근%라송원%설릉%리위%곡몽남%류원%황문휘%범서신%진기언%라건방%LUO Jianfang
主动脉夹层%腔内修复%感染%腔内修复术后综合征%预防性抗生素
主動脈夾層%腔內脩複%感染%腔內脩複術後綜閤徵%預防性抗生素
주동맥협층%강내수복%감염%강내수복술후종합정%예방성항생소
aortic dissection%endovascular repair%infection%postimplantation syndrome%prophylactic antibiotics
目的:研究预防性抗生素的应用是否能减少主动脉腔内修复术后感染及腔内修复术后综合征发生。方法入选从2011年9月到2012年10月接受主动脉腔内修复术并且住院资料完整患者。根据术前是否使用预防性抗生素分为预防性抗生素组(PA group)和非预防性抗生素组(non-PA group)。感染的判定由两位卫生副高级职称以上医生根据2001年中国人民共和国卫生部《医院感染诊断标准》进行,腔内修复术后综合征的诊断标准主要为排除感染的术后体温大于37.5℃。结果共入组95例患者,包括35例PA组和60例non-PA组。non-PA组一例发生感染相关的死亡,PA组一例患者出现支架近端逆撕形成Stanford A型夹层并死亡(1.67%vs 2.85%,P=1.00)。两组间术后感染发生率(5%vs 2.86%,P=1.000),住院时间(9.30±7.21 vs 10.06±5.69,P=0.094),感染相关的死亡率(1.67%vs 0%,P=1.00),术后发热发生率(70.90%vs 91.43%,P=0.20)。根据重复测量的方差分析,手术后不同时间点体温差异有统计学意义(F=19.831,P<0.001),而是否预防性应用抗生素组间差异不具有统计意义(F=0.978,P=0.326)。结论目前的数据不能证明预防性应用抗生素可以减少术后感染和腔内修复术后综合征发生率。但未使用预防性性抗生素的患者发生的术后感染可能预后更差。
目的:研究預防性抗生素的應用是否能減少主動脈腔內脩複術後感染及腔內脩複術後綜閤徵髮生。方法入選從2011年9月到2012年10月接受主動脈腔內脩複術併且住院資料完整患者。根據術前是否使用預防性抗生素分為預防性抗生素組(PA group)和非預防性抗生素組(non-PA group)。感染的判定由兩位衛生副高級職稱以上醫生根據2001年中國人民共和國衛生部《醫院感染診斷標準》進行,腔內脩複術後綜閤徵的診斷標準主要為排除感染的術後體溫大于37.5℃。結果共入組95例患者,包括35例PA組和60例non-PA組。non-PA組一例髮生感染相關的死亡,PA組一例患者齣現支架近耑逆撕形成Stanford A型夾層併死亡(1.67%vs 2.85%,P=1.00)。兩組間術後感染髮生率(5%vs 2.86%,P=1.000),住院時間(9.30±7.21 vs 10.06±5.69,P=0.094),感染相關的死亡率(1.67%vs 0%,P=1.00),術後髮熱髮生率(70.90%vs 91.43%,P=0.20)。根據重複測量的方差分析,手術後不同時間點體溫差異有統計學意義(F=19.831,P<0.001),而是否預防性應用抗生素組間差異不具有統計意義(F=0.978,P=0.326)。結論目前的數據不能證明預防性應用抗生素可以減少術後感染和腔內脩複術後綜閤徵髮生率。但未使用預防性性抗生素的患者髮生的術後感染可能預後更差。
목적:연구예방성항생소적응용시부능감소주동맥강내수복술후감염급강내수복술후종합정발생。방법입선종2011년9월도2012년10월접수주동맥강내수복술병차주원자료완정환자。근거술전시부사용예방성항생소분위예방성항생소조(PA group)화비예방성항생소조(non-PA group)。감염적판정유량위위생부고급직칭이상의생근거2001년중국인민공화국위생부《의원감염진단표준》진행,강내수복술후종합정적진단표준주요위배제감염적술후체온대우37.5℃。결과공입조95례환자,포괄35례PA조화60례non-PA조。non-PA조일례발생감염상관적사망,PA조일례환자출현지가근단역시형성Stanford A형협층병사망(1.67%vs 2.85%,P=1.00)。량조간술후감염발생솔(5%vs 2.86%,P=1.000),주원시간(9.30±7.21 vs 10.06±5.69,P=0.094),감염상관적사망솔(1.67%vs 0%,P=1.00),술후발열발생솔(70.90%vs 91.43%,P=0.20)。근거중복측량적방차분석,수술후불동시간점체온차이유통계학의의(F=19.831,P<0.001),이시부예방성응용항생소조간차이불구유통계의의(F=0.978,P=0.326)。결론목전적수거불능증명예방성응용항생소가이감소술후감염화강내수복술후종합정발생솔。단미사용예방성성항생소적환자발생적술후감염가능예후경차。
Objective To study the benefit of prophylactic antibiotics (PA) in totally percutaneous aortic endovascular repair (PEVAR) in the catheterization laboratory for reducing stent-graft infection and postimplantation syndrome (PIS). Methods The clinical data were analyzed of patients undergoing thoracic endovascular aortic repairs. The patients were divided into non-PA group and PA group according to the use of prophylactic antibiotics before PEVAR. The diagnosis of infection was made by two senior physicians with reference to Hospital Acquired Infection Diagnostic Criteria Assessment released by the Ministry of Health of China. Results The 95 enrolled patients included 35 with PA and 60 without PA group, who were comparable for baseline characteristics. Infection-related deaths occurred in 1 case in non-PA group and retrograde Stanford type A dissection and death occurred in 1 case in PA group (1.67%vs 2.85%, P=1.00). The PA and non-PA groups showed no significant difference in the incidence of postoperative infection (5%vs 2.86%, P=1.000), hospital stay (9.30±7.21 vs 10.06±5.69, P=0.094), infection-related mortality (1.67% vs 0%, P=1.00), or postoperative fever (70.90% vs 91.43%, P=0.20). The body temperature showed significant variations at different time points after procedure (F=19.831, P<0.001) irrelevant to the use of prophylactic antibiotics (F=0.978, P=0.326). Conclusion The current data do not support the benefit of PA in reducing postoperative infection and PIS in patients undergoing PEVAR, but the patients without PA may have worse clinical outcomes in the event of postoperative infections.