心脏外科术后深部胸骨切口感染临床特点及病原学分析

发布时间：2018-02-28 22:28

  本文关键词： 心脏外科术 深部胸骨切口感染 临床特点　出处：《中华医院感染学杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的分析心脏外科术后深部胸骨切口感染临床特点及病原学,为临床预防与治疗提供依据。方法回顾性分析2005年1月-2015年12月在医院行心脏手术患者3479例,其中术后发生深部胸骨切口感染的患者73例;分析不同临床分型的心脏外科术后深部胸骨切口感染临床特点,病原学及药敏分析结果。结果年龄30~55岁患者发生术后深部胸骨切口感染率更高,与30岁比较,差异有统计学意义(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℃、伤口裂开或者脓性分泌物、自发性疼痛、WBC10×109/L、低蛋白血症比例显著低于Ⅰ型患者,差异有统计学意义(P0.05),Ⅱ型X线或者CT显示纵膈增宽比例最高,差异有统计学意义(P0.05);73例患者32例病原菌诊断明确,分离出病原菌81株,其中革兰阴性菌44株,占54.3%,革兰阳性菌32株,占39.5%,真菌5株,占6.2%;革兰阴性菌耐药结果分析显示三种细菌对头孢唑林、头孢呋辛的耐药率均达到了100%;革兰阳性菌对青霉素G的耐药率达到了100%,而替加环素、利奈唑胺、万古霉素的敏感性较高。结论高龄患者心脏外科术后容易并发深部胸骨切口感染,其中以Ⅱ型多见。临床预防及治疗应结合临床特征以及病原学结果。
[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，

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