骨髓炎在深胸部伤口感染中:重新审视的一项单中心观察研究
Stephan Raab1, Tina Schaller2, Evaldas Girdauskas1
1Clinic of Cardiothoracic Surgery, University Hospital Augsburg, Faculty of Medicine, University of Augsburg, 86156 Augsburg, Germany.
Life (Basel, Switzerland)
|January 28, 2026
概括
深胸部伤口感染 (DSWI) 和胸部骨髓炎是不同的疾病. 在DSWI患者中,迅速地对骨质炎进行组织病理学检测对于有效的长期抗生素治疗和改善结果至关重要.
科学领域:
- 心血管外科心血管外科
- 传染性疾病 传染性疾病
- 整形外科手术 整形外科手术
背景情况:
- 心脏手术后的深胸部伤口感染 (DSWI) 是一个严重的并发症.
- DSWI经常与胸骨骨质炎混为一谈,可能会影响治疗策略.
研究的目的:
- 为了确定心脏手术后DSWI患者骨髓炎的患病率.
- 评估骨髓炎对DSWI治疗和胸重建结果的影响.
主要方法:
- 对130名患有DSWI (2014-2019) 的心脏手术患者进行了回顾性观察性研究.
- 收录标准:DSWI胸腔切除术后的情况. 干预措施:重新打开伤口,去除物质,负压治疗,微生物扫描和骨活检测骨髓炎的骨活检.
- 长期使用抗生素治疗已确认的骨髓炎.
主要成果:
- 在77% (102/130) 的DSWI患者中,骨质炎在组织病理学上得到证实.
- 在骨髓炎小组 (63%) 与非骨髓炎小组 (93%) 中,横侧胸骨骨折的频率较低.
- 在所有骨髓炎病例中检测到的病原体,而非骨髓炎病例中检测到的病原体为64%. 经过长期抗生素的胸部恢复稳定后,再感染率没有差异.
结论:
- 深胸部伤口感染 (DSWI) 和胸部骨髓炎不是可以互换的临床实体.
- 骨质炎的组织病理学诊断需要持续的长期抗生素治疗.
- 安全的初级胸固定对于减轻与DSWI相关的风险至关重要,无论骨髓炎是否存在.
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