Lancet:脑室腹腔分流术抗生素感染预防

2019-09-13 MedSci MedSci原创

研究认为,抗生素干预可显著降低脑室腹腔分流术后感染风险

脑室腹腔分流术治疗脑积水最常见的神经外科手术之一。植入式分流感染影响了15%的患者,导致长期住院治疗,多次手术,降低认知能力和生活质量。近日研究人员比较了抗生素、银夹分流与标准分流对减少感染风险的影响。

研究在英国和爱尔兰开展,首次接受脑室腹腔分流术的脑积水患者参与,随机接受抗生素预防(0.15%克林霉素和0.054%利福平)、浸银分流器分流或标准分流。研究的主要终点为感染导致的分流失败。

1605名患者,最大年龄91岁,标准分流组536人、抗生素干预组538人,浸银分流器分流组531人。1594完成分流且没有感染的迹象,其中标准组533人,抗生素组535人,浸银分流器分流组526人,平均随访22个月。32名标准治疗组、12名抗生素治疗组以及31名浸银分流器分流组患者发生感染(6% vs 2% vs 6%),抗生素干预的风险比值比为0.38,银分流器为0.99。标准治疗组,抗生素组以及银分流器组的不良事件率分别为25%,23%以及36%,未发生致命感染,主要的不良事件与瓣膜或导管功能有关。

研究认为,抗生素干预可显著降低脑室腹腔分流术后感染风险。

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    2020-08-19 howi
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    2019-09-15 tastas
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    2019-09-13 1244b27cm92暂无昵称

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