使用預防性抗生素是否可降低經皮穿腎取石手術之術後敗血症發生率：
統合分析及系統性文獻回顧

黃品叡、陳丕哲、沈正煌、林昌德、鄭明進

戴德森醫療財團法人嘉義基督教醫院 外科部 泌尿科

Does the use of Prophylactic Antibiotics Reduce the Incidence of Postoperative Sepsis in Percutaneous Nephrolithotomy: a Meta-Analysis and Systematic Literature Review

Pin-Jui Huang, Pi-Che Chen, Cheng-Huang Shen, Chang-Te Lin,Ming-Chin Cheng

Department of Urology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan

Introduction：

Urolithiasis is a common disease in urology, and sepsis is a common infectious complication after percutaneous nephrolithotomy (PCNL). This article hopes to compare whether the use of prophylactic antibiotics can reduce the incidence of postoperative sepsis after percutaneous nephrolithotomy by means of empirical methods, as a consideration for clinical treatment options.

Material and Method:

A comprehensive database search including Pubmed, Cochrane library, and Airiti Library was performed for retrospective studies till Octobor 2022 that assessed prophylactic antibiotics prescription and percutaneous nephrolithotomy. The primary outcome was incidence of postoperative sepsis. Pooled relative risk or hazard ratio with 95 percent confidence intervals were calculated for each outcome. The analytic process was generated with the meta-analysis software Review Manager (version 5.4 ).

Results:  

Four randomized controlled trial with a total 386 patients were identified for qualitative synthesis. The result showed that compared with the group without prophylactic antibiotics , the group using prophylactic antibiotics had a lower incidence of postoperative sepsis . The risk ratio (RR) was 0.39 , the 95% CI was 0.27 to 0.58 , the P value was <0.01 , and the heterogeneity (I square) was 0 % , indicating low heterogeneity .

Conclusions: