Tổng quan về nhiễm khuẩn vết mổ và kháng sinh dự phòng trong phẫu thuật mạch máu

Nguyễn Thị Thu Hà, Lê Thị Nguyệt Minh, Vũ Thùy Dung, Nguyễn Mai Hoa, Nguyễn Hoàng Anh, Ngô Gia Khánh, Vũ Anh Tuấn

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Tóm tắt

Đặt vấn đề: Phẫu thuật mạch máu là loại phẫu thuật tương đối phức tạp và đa dạng, với nhiều biến chứng như nhiễm khuẩn vết mổ, nhiễm khuẩn mảnh ghép, viêm phổi, nhồi máu cơ tim, xuất huyết, thuyên tắc mạch/huyết khối… trong đó, thường gặp là nhiễm khuẩn vết mổ và nhiễm khuẩn mảnh ghép. Hiện nay, kháng sinh dự phòng là biện pháp hiệu quả nhất để kiểm soát tình trạng này.


Phương pháp: Tổng hợp từ các nghiên cứu và hướng dẫn điều trị được tìm kiếm trên PubMed, GoogleScholar, Google.


Kết quả: 112 trong số 1227 kết quả được lựa chọn và đưa vào bài tổng quan, trong đó bao gồm 90 nghiên cứu và 22 hướng dẫn điều trị.


Kết luận: Trong phẫu thuật mạch máu, các hướng dẫn đa số khuyến cáo sử dụng kháng sinh dự phòng (KSDP) cho phẫu thuật động mạch chủ bụng và chi dưới, các phẫu thuật ghép vật liệu nhân tạo hoặc đặt stent. Phác đồ kháng sinh thường được lựa chọn là cephalosporin thế hệ 1 – C1G (cefazolin) hoặc cephalosporin thế hệ 2 – C2G (cefuroxim), dùng trong vòng 60 phút trước khi rạch da và ngừng sử dụng trong vòng 24 giờ sau phẫu thuật.

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Tài liệu tham khảo

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