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ANN SURG：结直肠手术前肠道准备方式比较

2018-03-27 MedSci MedSci原创

结直肠手术肠道准备比较
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手术部位感染是结直肠手术后并发症的主要原因，增加医疗花费。术前肠道准备对预防手术部位感染的作用一直存在争议。ANN SURG近期发表了一篇文章，研究肠道准备与结直肠手术后手术部位感染及其他术后并发症之间的关系。

手术部位感染是结直肠手术后并发症的主要原因，增加医疗花费。术前肠道准备对预防手术部位感染的作用一直存在争议。ANN SURG近期发表了一篇文章，研究肠道准备与结直肠手术后手术部位感染及其他术后并发症之间的关系。

作者回顾性分析了2012-2014年间32359例接受结直肠手术的患者。使用单因素和多因素分析进行研究。研究结果表明，26.7%的患者未接受肠道准备，36.6%的患者接受机械性肠道准备，3.8%口服抗生素，32.9%的患者进行机械性肠道准备+口服抗生素。机械性肠道准备与无肠道准备相比并未降低手术部位感染的风险。与之相反，口服抗生素和口服抗生素+机械性肠道准备与手术部位感染风险降低有关。口服抗生素和口服抗生素+机械性肠道准备还与吻合口漏风险降低，术后肠梗阻减少及住院时间缩短有关。肠道准备不会增加心脏/肾脏并发症风险。

文章最后认为，结直肠手术前仅进行机械性肠道准备预防手术部位感染是无效的，应被放弃。与之相反，口服抗生素和口服抗生素+机械性肠道准备与手术部位感染风险降低有关，且不会增加其他不良事件的风险。需要进行前瞻性研究评估口服抗生素的有效性。口服抗生素+机械性肠道准备应作为结直肠手术的常规以预防手术部位感染。

原始出处：
Koller Sarah E,Bauer Katherine,et al.Comparative Effectiveness and Risks of Bowel Preparationg Before Elective Colorectal Surgery.ANN SURG.April 2018 doi:10.1097/SLA.0000000000002159

本文系梅斯医学（MedSci）原创编译整理，转载需授权！

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    2018-04-09 青山颖钰

    学习了

    0

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    2018-03-28 crystal0564

    #结直肠#

    0

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    2018-03-28 wjcjjian

    #肠道准备#

    0

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    2018-03-27 明月清辉

    谢谢分享.学习了

    0

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