本文關(guān)鍵詞： 心臟外科術(shù) 深部胸骨切口感染 臨床特點　出處：《中華醫(yī)院感染學(xué)雜志》2017年05期 　論文類型：期刊論文

【摘要】：目的分析心臟外科術(shù)后深部胸骨切口感染臨床特點及病原學(xué),為臨床預(yù)防與治療提供依據(jù)。方法回顧性分析2005年1月-2015年12月在醫(yī)院行心臟手術(shù)患者3479例,其中術(shù)后發(fā)生深部胸骨切口感染的患者73例;分析不同臨床分型的心臟外科術(shù)后深部胸骨切口感染臨床特點,病原學(xué)及藥敏分析結(jié)果。結(jié)果年齡30~55歲患者發(fā)生術(shù)后深部胸骨切口感染率更高,與30歲比較,差異有統(tǒng)計學(xué)意義(P0.01);Ⅰ型15例,占20.5%,Ⅱ型43例,占58.9%,Ⅲ型15例,占20.5%。Ⅲ型患者T≥38℃、傷口裂開或者膿性分泌物、自發(fā)性疼痛、WBC10×109/L、低蛋白血癥比例顯著低于Ⅰ型患者,差異有統(tǒng)計學(xué)意義(P0.05),Ⅱ型X線或者CT顯示縱膈增寬比例最高,差異有統(tǒng)計學(xué)意義(P0.05);73例患者32例病原菌診斷明確,分離出病原菌81株,其中革蘭陰性菌44株,占54.3%,革蘭陽性菌32株,占39.5%,真菌5株,占6.2%;革蘭陰性菌耐藥結(jié)果分析顯示三種細(xì)菌對頭孢唑林、頭孢呋辛的耐藥率均達(dá)到了100%;革蘭陽性菌對青霉素G的耐藥率達(dá)到了100%,而替加環(huán)素、利奈唑胺、萬古霉素的敏感性較高。結(jié)論高齡患者心臟外科術(shù)后容易并發(fā)深部胸骨切口感染,其中以Ⅱ型多見。臨床預(yù)防及治療應(yīng)結(jié)合臨床特征以及病原學(xué)結(jié)果。
[Abstract]:Objective to analyze the clinical features and etiology of deep sternal incision infection after cardiac surgery, and to provide evidence for clinical prevention and treatment. Methods 3479 patients undergoing cardiac surgery in hospital from January 2005 to December 2015 were retrospectively analyzed. Among them 73 cases of deep sternal incision infection occurred after operation, and the clinical characteristics of deep sternal incision infection in different clinical types of cardiac surgery were analyzed. Results the infection rate of deep sternal incision in patients aged 30 to 55 years old was higher than that in 30 years old patients, the difference was statistically significant (P 0.01), 15 cases were type 鈪，

本文編號：1549267