复苏室紧急开胸术后纵隔感染

Mediastinal Infection Following Surgical Reexploration in ICU after Open Heart Surgery

对８１５例行体外循环心脏直视手术，４２例复苏室内紧急开胸抢救成功患者中，有１６例发生纵隔感染。结果：１０例死亡，死亡率６２．５％。结论：减少心脏直视手术后纵隔感染的关键是减少心脏手术后急性心包填塞、心跳骤停及心脏破裂等复苏室内紧急开胸的发生。早期使用有效的广谱抗菌素可以减少两次开胸术后纵隔感染的发生，但同时要注意菌群失调和二重感染。

Open heart surgery through median sternotomy had been performed on 815 patients in this hospital from June 1,1978 to July 31,1995.Sixteen of 42 patients after emergency reexploration in ICU developed mediastinal infection.The incidence and mortality of mediastinal infection were 38.1% and 62.5% respectively in this series.Mediastinal infection is the common and fetal complication after reexploration in ICU. The key to decrease mediastinal infection is to reduce cardiac tamponade,cardiac arrest and cardioclasis which lead to emergency reexploration in ICU.Early use of broad spectrum antibiotic after reexploration could reduce the incidence of mediastinal while flora imba lance and mixed infection should be careful to prevent.