{"title":"微创冠状动脉搭桥术围手术期抗生素应用的调查。","authors":"Xiuxiu Zhang, Chaohua Wang, Huanjun Yu, Yichang Song, Yingxue He, Tiantong Zhao, Tingting Liu, Xinyan Liu, Dapeng Yu","doi":"10.1007/s11748-025-02136-z","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To investigate the use of antimicrobials during the perioperative period of minimally invasive coronary artery bypass grafting (MICS CABG) and traditional open-heart bypass grafting. We aimed to determine whether the duration of perioperative antibiotic use and infection rate is significantly different between different surgical methods.</p><p><strong>Methods: </strong>A total of 471 cases of coronary artery bypass grafting (CABG) were collected from January 2019 to December 2022. Patients were divided into minimally invasive group (229 cases) and a conventional group (242 cases) according to the type of surgery. We compared differences in the duration of antimicrobial use and infection rates between the two groups.</p><p><strong>Results: </strong>Compared with the conventional group, the minimally invasive group had a significantly shorter average duration of antimicrobial therapy [(1.95 ± 2.40) d vs. (4.67 ± 5.89) d, P < 0.001], a higher rate of short antibiotic treatment duration (T ≤ 24 h) [51.97% vs. 7.02%, P < 0.001], lower postoperative pneumonia rate [38.86% vs. 56.20%, P < 0.001], lower positive rate of blood and surgical site sample culture (1 case and 0 case) vs. (7 cases and 3 cases), P < 0.001. Subgroup analysis of different durations of antimicrobial treatment (T ≤ 24 h, 24 h < T ≤ 48 h, and 48 h < T ≤ 96 h) in the minimally invasive group showed that there was no statistically significant difference in the incidence of infection among the various medication durations (P > 0.05).</p><p><strong>Conclusion: </strong>Compared with traditional surgery, MICS CABG requires a significantly shorter duration of perioperative antibiotic treatment duration and a reduced incidence of infection. Extending the duration of antibiotic treatment did not reduce the incidence of infection.</p><p><strong>Trial registration: </strong>chictr.org.cn ChiCTR2400091571.</p>","PeriodicalId":12585,"journal":{"name":"General Thoracic and Cardiovascular Surgery","volume":" ","pages":""},"PeriodicalIF":1.1000,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"A survey on perioperative antibiotic use for minimally invasive coronary artery bypass grafting.\",\"authors\":\"Xiuxiu Zhang, Chaohua Wang, Huanjun Yu, Yichang Song, Yingxue He, Tiantong Zhao, Tingting Liu, Xinyan Liu, Dapeng Yu\",\"doi\":\"10.1007/s11748-025-02136-z\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To investigate the use of antimicrobials during the perioperative period of minimally invasive coronary artery bypass grafting (MICS CABG) and traditional open-heart bypass grafting. We aimed to determine whether the duration of perioperative antibiotic use and infection rate is significantly different between different surgical methods.</p><p><strong>Methods: </strong>A total of 471 cases of coronary artery bypass grafting (CABG) were collected from January 2019 to December 2022. Patients were divided into minimally invasive group (229 cases) and a conventional group (242 cases) according to the type of surgery. We compared differences in the duration of antimicrobial use and infection rates between the two groups.</p><p><strong>Results: </strong>Compared with the conventional group, the minimally invasive group had a significantly shorter average duration of antimicrobial therapy [(1.95 ± 2.40) d vs. (4.67 ± 5.89) d, P < 0.001], a higher rate of short antibiotic treatment duration (T ≤ 24 h) [51.97% vs. 7.02%, P < 0.001], lower postoperative pneumonia rate [38.86% vs. 56.20%, P < 0.001], lower positive rate of blood and surgical site sample culture (1 case and 0 case) vs. (7 cases and 3 cases), P < 0.001. Subgroup analysis of different durations of antimicrobial treatment (T ≤ 24 h, 24 h < T ≤ 48 h, and 48 h < T ≤ 96 h) in the minimally invasive group showed that there was no statistically significant difference in the incidence of infection among the various medication durations (P > 0.05).</p><p><strong>Conclusion: </strong>Compared with traditional surgery, MICS CABG requires a significantly shorter duration of perioperative antibiotic treatment duration and a reduced incidence of infection. Extending the duration of antibiotic treatment did not reduce the incidence of infection.</p><p><strong>Trial registration: </strong>chictr.org.cn ChiCTR2400091571.</p>\",\"PeriodicalId\":12585,\"journal\":{\"name\":\"General Thoracic and Cardiovascular Surgery\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.1000,\"publicationDate\":\"2025-03-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"General Thoracic and Cardiovascular Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s11748-025-02136-z\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"General Thoracic and Cardiovascular Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s11748-025-02136-z","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
目的:探讨微创冠状动脉旁路移植术(MICS CABG)与传统心内直视旁路移植术围手术期抗菌药物的使用情况。我们的目的是确定围手术期抗生素使用时间和感染率在不同手术方式之间是否有显著差异。方法:收集2019年1月至2022年12月行冠状动脉旁路移植术(CABG)患者471例。根据手术方式将患者分为微创组229例和常规组242例。我们比较了两组患者抗菌药物使用时间和感染率的差异。结果:与常规组相比,微创组抗菌药物治疗的平均持续时间明显缩短[(1.95±2.40)d比(4.67±5.89)d, P < 0.05]。结论:与传统手术相比,MICS冠脉搭桥围手术期抗生素治疗时间明显缩短,感染发生率明显降低。延长抗生素治疗的时间并没有减少感染的发生率。试验注册:chictr.org.cn ChiCTR2400091571。
A survey on perioperative antibiotic use for minimally invasive coronary artery bypass grafting.
Objective: To investigate the use of antimicrobials during the perioperative period of minimally invasive coronary artery bypass grafting (MICS CABG) and traditional open-heart bypass grafting. We aimed to determine whether the duration of perioperative antibiotic use and infection rate is significantly different between different surgical methods.
Methods: A total of 471 cases of coronary artery bypass grafting (CABG) were collected from January 2019 to December 2022. Patients were divided into minimally invasive group (229 cases) and a conventional group (242 cases) according to the type of surgery. We compared differences in the duration of antimicrobial use and infection rates between the two groups.
Results: Compared with the conventional group, the minimally invasive group had a significantly shorter average duration of antimicrobial therapy [(1.95 ± 2.40) d vs. (4.67 ± 5.89) d, P < 0.001], a higher rate of short antibiotic treatment duration (T ≤ 24 h) [51.97% vs. 7.02%, P < 0.001], lower postoperative pneumonia rate [38.86% vs. 56.20%, P < 0.001], lower positive rate of blood and surgical site sample culture (1 case and 0 case) vs. (7 cases and 3 cases), P < 0.001. Subgroup analysis of different durations of antimicrobial treatment (T ≤ 24 h, 24 h < T ≤ 48 h, and 48 h < T ≤ 96 h) in the minimally invasive group showed that there was no statistically significant difference in the incidence of infection among the various medication durations (P > 0.05).
Conclusion: Compared with traditional surgery, MICS CABG requires a significantly shorter duration of perioperative antibiotic treatment duration and a reduced incidence of infection. Extending the duration of antibiotic treatment did not reduce the incidence of infection.
期刊介绍:
The General Thoracic and Cardiovascular Surgery is the official publication of The Japanese Association for Thoracic Surgery and The Japanese Association for Chest Surgery, the affiliated journal of The Japanese Society for Cardiovascular Surgery, that publishes clinical and experimental studies in fields related to thoracic and cardiovascular surgery.