【摘要】：目的探討心臟外科術后患者深部胸骨切口感染的臨床特征、病原菌分布及耐藥性的情況,為臨床診療提供理論依據(jù)。方法回顧性分析醫(yī)院收治的心臟外科手術后深部胸骨切口感染患者69例;對比不同臨床分型的深部胸骨切口感染患者的臨床表現(xiàn)、實驗室檢查以及影像學檢查結果;分析深部胸骨切口感染的病原菌分布及主要病原菌的耐藥性情況。結果Ⅲ型深部胸骨切口感染體溫≥38℃的比例、自發(fā)性疼痛的比例、白細胞計數(shù)10×109/L的比例均顯著低于Ⅰ型和Ⅱ型深部胸部切口感染(P0.05);Ⅲ型深部胸骨切口感染術口裂開或見膿性分泌物的比例顯著低于Ⅱ型深部胸骨切口感染(P0.05);Ⅲ型深部胸骨切口感染低蛋白血癥的比例顯著低于Ⅰ型深部胸骨切口感染(P0.05);本研究共培養(yǎng)出病原菌76株,其中,革蘭陰性菌42株(55.26%),革蘭陽性菌30株(39.47%),真菌4株(5.26%);銅綠假單胞菌對頭孢他啶、頭孢吡肟、亞胺培南和美羅培南均有較高的敏感性,耐藥率均為16.67%;鮑曼不動桿菌對臨床常用的抗菌藥物均表現(xiàn)出高度的耐藥性;金黃色葡萄球菌和表皮葡萄球菌對青霉素G和克拉霉素均表現(xiàn)出高度的耐藥性,而對替加環(huán)素、利奈唑胺和萬古霉素均敏感,耐藥率均為0.00%。結論心臟外科術后應密切觀察患者的病情變化,及早發(fā)現(xiàn)深部胸骨切口感染并規(guī)范應用抗菌藥物,改善患者的預后。
[Abstract]:Objective to investigate the clinical characteristics, distribution of pathogens and drug resistance of deep sternum incision infection after cardiac surgery, and to provide theoretical basis for clinical diagnosis and treatment. Methods Sixty-nine patients with deep sternal incision infection after cardiac surgery were retrospectively analyzed, and the clinical manifestations, laboratory and imaging findings of patients with deep sternal incision infection of different clinical types were compared. To analyze the distribution of pathogenic bacteria and drug resistance of main pathogens in deep sternal incision infection. Results the proportion of body temperature 鈮，

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