急性胆囊炎是普外科急腹症中的常见疾病,腹腔镜胆囊切除术(LC)是其主要治疗方法。然而,围术期感染仍然是术后并发症的重要风险因素。抗生素在急性胆囊炎围术期应用的研究旨在明确其预防策略、最佳使用时机及效果。研究表明,合理使用预...急性胆囊炎是普外科急腹症中的常见疾病,腹腔镜胆囊切除术(LC)是其主要治疗方法。然而,围术期感染仍然是术后并发症的重要风险因素。抗生素在急性胆囊炎围术期应用的研究旨在明确其预防策略、最佳使用时机及效果。研究表明,合理使用预防性抗生素能够降低手术部位感染(SSI)率,特别是在高风险患者中。然而,预防性抗生素的普遍应用存在争议,一些研究显示其并不能显著降低低风险患者的术后感染率。尽管如此,抗生素在围术期的选择和使用仍需基于患者具体情况和感染风险。本文综述了抗生素在急性胆囊炎围术期应用的现状与进展,为临床医生提供参考,以优化抗生素使用策略,减少术后感染和抗生素耐药性风险。Acute cholecystitis is a common disease in general surgery acute abdomen, and laparoscopic cholecystectomy (LC) is its main treatment. However, perioperative infection remains an important risk factor for postoperative complications. The study on the perioperative use of antibiotics in acute cholecystitis aims to clarify its preventive strategies, optimal timing of use and effectiveness. Studies have shown that the judicious use of prophylactic antibiotics can reduce the rate of surgical site infection (SSI), especially in high-risk patients. However, the generalized use of prophylactic antibiotics is controversial, and some studies have shown that they do not significantly reduce postoperative infection rates in low-risk patients. Nonetheless, the selection and use of antibiotics in the perioperative period needs to be based on patient-specific circumstances and infection risk. This article reviews the current status and progress of antibiotic use in the perioperative period of acute cholecystitis to provide clinicians with a reference to optimize antibiotic use strategies and reduce the risk of postoperative infection and antibiotic resistance.展开更多
急性胆囊炎是常见的急腹症之一。近年来,随着微创技术的进步和外科医师腹腔镜水平的提升,腹腔镜下胆囊切除术已成为治疗急性胆囊炎的金标准,因其创伤小、操作简单、术后恢复快而备受推崇。但对于高龄、合并严重基础疾病的高危患者而言,...急性胆囊炎是常见的急腹症之一。近年来,随着微创技术的进步和外科医师腹腔镜水平的提升,腹腔镜下胆囊切除术已成为治疗急性胆囊炎的金标准,因其创伤小、操作简单、术后恢复快而备受推崇。但对于高龄、合并严重基础疾病的高危患者而言,急诊行LC存在着较高的手术风险。超声引导下经皮经肝胆囊穿刺引流术能够有效减轻胆囊压力、迅速缓解感染症状,目前已逐渐成为有手术禁忌的患者首选的治疗措施。本文对PTGBD的现状和问题进行综述,并对其未来前景进行讨论。Acute cholecystitis is one of the common acute abdominal diseases. In recent years, with the advancement of minimally invasive technology and the improvement of surgeons’ laparoscopic level, laparoscopic cholecystectomy has become the gold standard for the treatment of acute cholecystitis, which is highly respected because of its small trauma, simple operation, and fast postoperative recovery. However, for high-risk patients of advanced age and combined with severe underlying diseases, there is a high surgical risk of performing LC in emergency. Ultrasound-guided percutaneous transhepatic gallbladder puncture and drainage (PTGBD) can effectively reduce gallbladder pressure and rapidly alleviate the symptoms of infection, and has gradually become the preferred therapeutic measure for patients with contraindications to surgery. This article reviews the current status and problems of PTGBD and discusses its future prospects.展开更多
文摘急性胆囊炎是普外科急腹症中的常见疾病,腹腔镜胆囊切除术(LC)是其主要治疗方法。然而,围术期感染仍然是术后并发症的重要风险因素。抗生素在急性胆囊炎围术期应用的研究旨在明确其预防策略、最佳使用时机及效果。研究表明,合理使用预防性抗生素能够降低手术部位感染(SSI)率,特别是在高风险患者中。然而,预防性抗生素的普遍应用存在争议,一些研究显示其并不能显著降低低风险患者的术后感染率。尽管如此,抗生素在围术期的选择和使用仍需基于患者具体情况和感染风险。本文综述了抗生素在急性胆囊炎围术期应用的现状与进展,为临床医生提供参考,以优化抗生素使用策略,减少术后感染和抗生素耐药性风险。Acute cholecystitis is a common disease in general surgery acute abdomen, and laparoscopic cholecystectomy (LC) is its main treatment. However, perioperative infection remains an important risk factor for postoperative complications. The study on the perioperative use of antibiotics in acute cholecystitis aims to clarify its preventive strategies, optimal timing of use and effectiveness. Studies have shown that the judicious use of prophylactic antibiotics can reduce the rate of surgical site infection (SSI), especially in high-risk patients. However, the generalized use of prophylactic antibiotics is controversial, and some studies have shown that they do not significantly reduce postoperative infection rates in low-risk patients. Nonetheless, the selection and use of antibiotics in the perioperative period needs to be based on patient-specific circumstances and infection risk. This article reviews the current status and progress of antibiotic use in the perioperative period of acute cholecystitis to provide clinicians with a reference to optimize antibiotic use strategies and reduce the risk of postoperative infection and antibiotic resistance.
文摘急性胆囊炎是常见的急腹症之一。近年来,随着微创技术的进步和外科医师腹腔镜水平的提升,腹腔镜下胆囊切除术已成为治疗急性胆囊炎的金标准,因其创伤小、操作简单、术后恢复快而备受推崇。但对于高龄、合并严重基础疾病的高危患者而言,急诊行LC存在着较高的手术风险。超声引导下经皮经肝胆囊穿刺引流术能够有效减轻胆囊压力、迅速缓解感染症状,目前已逐渐成为有手术禁忌的患者首选的治疗措施。本文对PTGBD的现状和问题进行综述,并对其未来前景进行讨论。Acute cholecystitis is one of the common acute abdominal diseases. In recent years, with the advancement of minimally invasive technology and the improvement of surgeons’ laparoscopic level, laparoscopic cholecystectomy has become the gold standard for the treatment of acute cholecystitis, which is highly respected because of its small trauma, simple operation, and fast postoperative recovery. However, for high-risk patients of advanced age and combined with severe underlying diseases, there is a high surgical risk of performing LC in emergency. Ultrasound-guided percutaneous transhepatic gallbladder puncture and drainage (PTGBD) can effectively reduce gallbladder pressure and rapidly alleviate the symptoms of infection, and has gradually become the preferred therapeutic measure for patients with contraindications to surgery. This article reviews the current status and problems of PTGBD and discusses its future prospects.
