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Daniel M S Magalhães^1,2, Maurilio O Deininger^1,2, Orlando Gomes de Oliveira^1,2

¹Hospital Unimed João Pessoa - Alberto Urquiza Wanderley, João Pessoa, Paraíba, Brazil.

Brazilian journal of cardiovascular surgery

|July 4, 2023

概括

常规使用双边内胸动脉 (BITA) 移植与非抽动冠状动脉旁路移植 (OPCABG) 显示低深胸部伤口感染 (DSWI) 率. 糖尿病和肥胖是这些患者DSWI的关键风险因素.

科学领域:

心血管外科心血管外科
胸部外科手术胸部外科手术
手术感染手术感染

背景情况:

双边内胸动脉 (BITA) 移植提供了生存益处,但由于深胸部伤口感染 (DSWI) 问题而未得到充分利用.
无冠状动脉旁路移植 (OPCABG) 是冠状动脉疾病的常见手术方法.

研究的目的:

评估与日常使用BITA接种与OPCABG结合使用的DSWI发生率.
确定在接受BITA和OPCABG的患者中导致DSWI的危险因素.

主要方法:

在2010年1月至2020年12月期间,对1207名接受隔离冠状动脉旁路移植的患者进行了回顾性分析.
所有患者都试图接受OPCABG,在适当时使用BITA进行左冠状动脉移植. DSWI被定义为需要手术或抗生素的感染.
多重线性回归被用于分析DSWI风险因素.

主要成果:

整体DSWI发生率低,为0.58%.
在BITA (70.6%) 和单个内胸动脉 (29.4%) 使用之间,在DSWI率上没有发现显著差异 (P=0.680).
对DSWI的独立风险因素包括糖尿病,不稳定性心痛,先前心肌梗塞,左心室排气分数减少和紧急手术. 糖尿病,高脂血症和肥胖症在DSWI组中更为普遍.

结论:

在OPCABG之后,常规使用骨化BITA移植与令人满意的DSWI发病率和手术死亡率有关.
这项研究强调了在OPCABG中进行BITA移植的安全性,如果经常进行的话.
识别和管理糖尿病等风险因素对于尽量减少这些患者的DSWI至关重要.

关键词:

胸痛是一种心脏病.抗菌剂抗菌剂抗菌剂冠状动脉绕道 (bypass) 是一种冠状动脉绕道.冠状动脉血管冠状动脉血管没有机,没有机不稳定的不稳定的伤口感染伤口感染

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