血管外科相关感染诊治

Diagnosis and treatment of surgical site infection in vascular surgery

手术部位感染(surgical site infection,SSI)是院内感染的重要组成部分,血管外科除了具备其他外科学科的一般特征,其特殊之处在于各种人工移植物的广泛应用,一旦出现术后SSI,后果往往是灾难性的。金黄色葡萄球菌和凝固酶阴性葡萄球菌是血管外科SSI最常见的致病菌。血管外科SSI缺乏典型的临床表现,通过临床症状、实验室检查和特殊的影像学检查可以诊断。发生血管外科SSI,原则上需要移除感染的血管移植物,并选用合适的抗生素治疗,但由于移植物感染程度和范围各异,临床医生应根据血管移植物感染的具体情况,来制定个体化治疗方案。

Surgical site infection （SSI） is an important component of hospital acquired infections. The most significant feature of vascular surgery- different fi＇om other surgeries is frequent application of artificial grafts. Once SSI occurs after vascular operations with grafts, it might results in a disaster. Staphylococcus aureus and eoagulase-negative staphyh）eoccus are the most common pathogenic bacteria for SSI after vascular surgery. Although SS1 in vascular surgery often lacks of typical clinical characters, some clinical symptoms, laboratory data and certain imaging procedures may help to diagnose. In most cases of SSI after vascular procedures, the artificial grafts must be removed and sensitive antibiotics should be administered. However, for different cases, personalized management plan should be made depending on the severity and location of SSI.