心脏直视手术后医院感染调查分析

Survey and analysis of hospital infection after open-heart operation

目的 探讨心脏直视手术后69例发生医院感染的相关因素。方法 回顾性分析心脏直视手术后69 例医院感染的临床资料,就手术前基础心脏病变,手术环节,不同心肌保护方法在医院感染发生中的作用进行统计分析。结果 心内直视手术4 850例中,发生医院感染69例,感染发生率为1.42%,直接引起死亡6例,病死率8.70%;肺部感染和纵隔感染发生率最高,感染性心内膜炎最凶险;医院感染的病原菌广,多重耐药菌发生率高。结论 医院感染的发生与手术前基础心脏病变严重有关,手术环节是手术后发生感染的重要因素,净化手术室和良好的心肌保护措施可降低医院感染发生率,降低手术后病死率。

Objective To investigate the hospital infection after open-heart surgery and the related risk factors in 69 cases.Methods The clinical data of 69 patients were studied retrospectively.The relationship between hospital infection and the underlying heart diseases,conditions of operating room,different methods of myocardial protection during operation,duration of mechanical ventilation were analyzed statistically.Results Hospital infection was documented in 69 (1.42%) of the 4850 cases receiving open-heart surgery.The mortality was 8.70% (6/69).Pulmonary and mediastinal septum were the most common site of infection.Infectious endocarditis was the dangerous complication with high death rate.The pathogens of hospital infections after open-heart surgery were greatly varied with high prevalence of multiple antibiotic resistance.Conclusions Hospital infection was associated with the severity of preoperative underlying heart diseases.Open-heart procedure was the important factor contributing to post-operative infections.Bio-clean operating room and better myocardial protection can decrease the incidence and mortality of post-operative hospital infections.