心脏手术后纵隔感染的防治体会

A treatment and prevention experience about mediastinal infection following open-heart operation

目的 探讨手术后纵隔感染的治疗方法和预防措施。方法对１５例手术后纵隔感染患者的临床资料进行了分析。结果结果表明发生率为１．０％，术后心肺功能低下、转流时间过长、气管切开、二次开胸手术是导致感染的重要因素。全组死亡 ４例，死亡率为 ２６． ７％，其中 ２例死于纵隔感染。结论彻底清创、纵隔冲洗是治疗纵隔感染的主要方法。提出了预防纵隔感染的各种措施。

OBJECTIVE To study methods of treatment and prevention of postoperational mediastinal infections. METHODS Fifteen cases with mediastinal infection occurred in 1 500 patients who had undergone open heat surgery under CPS were reviewed in the period of 1980-Oct 1998. RESULTS The over-all incidence wes 1. 0%. Analysis of the clinical matchal showed that mediastinal infection wes mostly associated with the following predisposing factors: severe circulatory and/or respiratory com- plications;prolonged CPB time; tracheostomy; rethoracotomy. Four cases died in this group. The mortality rate was 26. 7%. Among them, 2 died of multisystemic complications and others died of severe mediastinal infection. CONCLUSIONS Radical mediastinal debridement and continuous mediastinal irrgation were important methods in treating mediastinal infection. Four cas- es died in thes group. The mortality rate wes 26. 7 %. Among them, 2 died of multisystemic complication and others died of se- severe mediastinal infection.