心脏外科术后感染的诊断和抗菌治疗

Diagnosis and antibiotic therapy of postoperative infection after cardiac surgery

感染是心脏外科术后常见的并发症之一,严重影响患者预后,甚至导致死亡。目前,对于心脏外科术后感染的诊治仍然存在一定的误区,呕待解决。本文结合国内外感染相关指南以及国内心血管外科术后医院感染的发生部位、病原学分布及耐药性特点,系统梳理了心脏外科术后常见感染的诊疗过程,以期规范心脏外科术后抗菌药物的合理使用、提升感染治愈率、降低病死率、减少细菌耐药率。

Infection is one of the commonest complications after cardiac surgery, which associated with increased the length of ICU stay, healthcare costs and mortality. At present, there are still some misunderstanding in the diagnosis and treatment of infection after cardiac surgery, which need to be solved urgently. We outline the clinical process of diagnosis-treatment-reassessment-adjustment and standardize physician's behavior for postoperative infection based on the recent guidelines and consensus, in order to improve the antibiotic management, decrease the infection rate and bacterial resistance after cardiac surgery.