Đánh giá kết quả sử dụng kháng sinh dự phòng cefuroxime trong phẫu thuật tán sỏi thận qua da đường hầm nhỏ tại Bệnh viện Trung ương Quân đội 108

Abstract

Objective: To evaluate the results of using cefuroxime as prophylactic antibiotic in PCNL. Subject and method: 56 patients undergoing PCNL (percutaneous nephrolithotomy) from February 2022 to February 2023 at the Department of Urology, 108 Military Central Hospital, were given prophylactic antibiotics cefuroxim 750mg - 1.5g (750mg injection for patients < 70kg), 1.5g injection in patients ≥ 70kg), a single intravenous dose 30 minutes before surgery. Selection criteria: Patients without clinical and subclinical bacteriuria, 24h postoperative follow-up: Fever, systemic inflammatory response syndrome, complete blood count, bacteriuria culture. Result: 24 hours after PCNL: There were 8 patients with fever (14.3%), the percentage of white blood cells (BC) 14.3 ± 2.56 (p=0.17). SIRS had 2/56 (3.6%). There were 1/56 (1.8%) patients with positive bacteriuria and blood cultures, 48/56 patients with urinary catheter removed and renal drainage after 2 days, 8/56 patients with urinary catheter and catheter removed. kidney retention > 3 days due to post-operative fever. The average operative time was 41.16 ± 17.14 (20-115) min, discharge after 3.78 ± 1.1 days. Conclusion: Cefuroxim 750mg is used as a prophylactic antibiotic, administered intravenously as a single injection in PCNL, resulting in no postoperative infection of 85.7%, which can replace antibiotics for surgical coverage. Surgery for patients without urinary tract infection, short operative time without intraoperative complications.