抗生素在急性胆囊炎围术期应用的研究进展

Advances in the Perioperative Use of Antibiotics in Acute Cholecystitis

摘要: 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。

Abstract: 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.