心脏手术后感染率与体外循环过程中的相关因素分析

Analysis of CPB interrelating factors for infection rate operation on heart postoperative

目的 探讨心脏手术后感染率与体外循环过程中的相关因素的关系。方法 总结分析 1999年 11月～ 2 0 0 0年 11月 10 5 3例体外循环心内直视术后发生感染的患者其感染率与体外循环过程中体外循环转流时间、氧合器的种类、术中应用抗菌素种类、年龄、性别等与感染的关系。结果 10 5 3例患者中体外循环转流时间 <1h 4 80例 ,感染人数 2 2例 ,感染率 4 .5 8% ;CPB时间 1～ 2h 4 4 8例 ,感染人数 31例 ,感染率 6 .92 % ;CPB时间 >2h 12 5例 ,感染人数 16例 ,感染率 12 .8% ;应用进口膜式氧合器 4 4 0例 ,感染人数 36例 ,感染率 8.18% ;应用西京鼓泡式氧合器 6 13例 ,感染 34例 ,感染率 5 .5 5 % ;应用一代头孢菌素 191例 ,感染 12例 ,感染率6 .2 8% ;应用二代头孢菌素 6 5 6例 ,感染 4 4例 ,感染率 6 .71% ;应用三代头孢菌素 2 0 6例 ,感染 14例 ,感染率 6 .80 % ;年龄 <1岁 4 8例 ,感染 11例 ,感染率 2 2 .9% ;1≤年龄 <3岁 14 7例 ,感染 17例 ,感染率 11.5 6 % ;3≤年龄<12岁 35 7例 ,感染 2 0例 ,感染率 5 .6 % ;年龄 >12岁 5 0 1例 ,感染 2 2例 ,感染率 4 .4 %。 10 5 3例患者中男性5 99例 ,感染 34例 ,感染率 3.2 2 % ;女性 4 5 4例 ,感染 36例 ,感染率 3.4 1%。

Objective:To analyze the mutual relation of operation on heart postoperative infection rate with the factors during cardiopulmonary bypass (CPB) .Methods: We reviewed the infection rate of operation on heart postoperative with cardiopulmonary bypass duration, the kinds of Oxygenator, the patients age, sex,and the kinds of antibiotic he used during CPB.Results: In 1053 cases, There were 480 cases the CPB duration less than one hour, the infection cases were 22, infection rate was 4.58%, There were 448 cases the CPB duration more than one hour and less than two hours. The infection cases were 31, tile infection rate was 6.92%, There were 125 cases tile CPB duration more than two hours, the infection cases were 16, the infection rate was12.8%. In 1053 cases,there were 440 cases used membrane Oxygenator. In this group, there were 36 cases infection, the infection rate was 8.8%; there were 653 cases used XIJING bubble Oxygenator. The infection cases were 34, the infection rate was 5.55%. The kinds of antibiotic and sex did not with the infection rate ( P >0.1). There was dear relation between the infection rate and patients age.Conclusions: There are obviously correlation on the infection rate of patients after operation on heart with CPB duration and the patients age( P <0.05, P < 0.01); the infection rate has nothing to do with the kind of Oxygenator, the sex and the kind of antibiotic( P > 0.05).