Clinical Significance Of Antibiotic Prophylaxis In Perioperative Period Of Intravascular Interventional Therapy

Objective:To investigate the protective effect of antibiotic prophylaxis againstpostoperative infection in perioperative period of intravascularinterventional therapy.Methods:Clinical data of inpatients with liver cancer undergoing transarterialchemoembolization(TACE) from January2007to March2013or inpatientswith cirrhosis undergoing transjugularintrahepatic portosystemicshunts(TIPS) from January2011to March2013were collected andretrospectively analyzed. We classified the inpatients into antibioticprophylaxis treatment group and no antibiotic prophylaxis treatment group,compared the postoperative infection rate, and analyzed the risk factors ofinfection.Results:1. There were538patients undergoing TACE, including501malesand37females.The number of patients undergoing TIPS was61,which contained47males and14females.According to antibiotic prophylaxis inperioperative period of intravascular interventional therapy. Thepostoperative infection rate of antibiotic prophylaxis treatment group andno antibiotic prophylaxis treatment group about TACE procedures were16.7%（60/359）and20.1%(36/179) respectively (P=0.33).2. The incidence rate of respiratory tract infection, unexplainedinfection, peritonitis, urinary infection, sepsis, biliary tract infection, liverabscess, pleuritis and the digestive tract infection between TACE antibioticprophylaxis treatment group and TACE no antibiotic prophylaxis treatmentgroup didn,t reach statistical significance(P>0.05).3.Univariate and multivariate analysis indicated that Child-Pughscore and operation time over two hours were independent risk factors.4.The postoperative infection rate of antibiotic prophylaxis treatmentgroup of TIPS procedures was33.3(5/15) and that of no antibioticprophylaxis treatment group was34.8(16/46)（P=0.92）.5. The incidence rate of respiratory tract infection, peritonitis, urinaryinfection, sepsis and unexplained infection between TIPS antibioticprophylaxis treatment group and TIPS no antibiotic prophylaxis treatmentgroup didn,t reach statistical significance(P>0.05).6. multivariate analysis showed that age and Child-Pugh score were independent risk factors.Conclusions:Antibiotic prophylaxis in patients with Child-Pugh A undergoing TACEor TIPS therapy is not routinely necessary. However, it is more reasonable touse appropriate antibiotics for the high-risk group who have poor liverfunction, long operation time and advanced age.