体外循环及抗生素对瓣膜置换术患者咽部菌群及手术切口细菌定植的影响

Effects of Extracorporeal Circulation and Antibiotics on the Pharyngeal Florae and Bacterial Colonization of Incisional Wound in Patients having Prosthetic Valve Replacement

为了解体外循环（ＣＰＢ）及抗生素对瓣膜置换术患者咽部菌群及手术切口细菌定植的影响。ＣＰＢ前及后５天进行了咽部和手术切口采样细菌培养。术后咽部细菌明显减少（Ｐ＜００１），咽部菌群构成中草绿色链球菌、奈瑟氏菌增加，四联球菌减少（Ｐ＜００１）。术后６例患者出现手术切口细菌定植，这种细菌定植与监护室观察及呼吸机使用时间有关。

Division of Cardiothoracic Surgery,Department of Laboratory Medicine,First University Hospital,West China University of Medical Sciences,Chengdu,Sichuan,610041 To study the effects of extracorporeal circulation and antibiotics on the pharynseal florae and bacterial colonization of incisional waund in patents with prosthetic vaelve replacement.Cultunes of the florae of throat and the operative fields were done before aperation and on the fifth day after operation,respectively.The bacterial florae of throat decreased significantly after operation(P<0.01).Also there were obvious changes of the constituent ratio of throat florae(P<0.01).The constituent rstio of streptococcus viridans and Neisseria decreased and that of Gaffkya tetragema increased postoperatively.There were 6 patients who had postoperative bacterial wound colonization.The colonization was related to the duration of ICU observation and ventilation.It was belived htat it would be beneficial to patients with prosthetic valve replacement from preventing potential hospital infection to the possibility of shorten if pessible,duation ICU observation and ventilation.