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在心肺外科手术后与心肺绕道心脏外科手术后发生的高乳糖血和感染之间的关联:一个多中心回顾性研究
Yewei Shi1,2, Yusu Wang2, Jielei Pan2
1Department of Anesthesiology, Affiliated Hospital of Guizhou Medical University, Guiyang, China.
World journal of surgery
|February 13, 2026
概括
在手术期间的手术性乳糖过高,或手术期间的高血糖,独立地增加了心脏手术患者手术后感染的风险. 保持乳酸水平低于2.7mmol/L可能会降低感染风险.
科学领域:
- 心脏病学 心脏病学
- 手术感染预防 手术感染预防
- 关键护理医学 关键护理医学
背景情况:
- 手术后感染是心脏外科手术的一个重要问题.
- 心肺绕道 (CPB) 与可能影响感染风险的生理变化有关.
- 在手术期间的乳酸盐水平是组织低 perfusion 和不良结果的潜在标志物.
研究的目的:
- 为了确定手术后的超乳糖血症是否是术后感染风险的独立预测因素.
- 确定手术期间血中乳酸盐水平与心脏手术患者接受CPB的感染风险增加相关的值.
主要方法:
- 一项对4970名接受CPB的心脏手术患者的回顾性研究.
- 在手术期间发生的乳糖过高,定义为血中乳糖>2.0 mmol/L.
- 统计分析以评估高乳糖血症和术后感染之间的关联,调整混因素.
主要成果:
- 术后感染发生在14.49%的患者中.
- 患有感染的患者在手术期间的乳酸盐峰值水平显著更高 (3.5比2.6毫摩尔/升).
- 在手术期间出现的乳糖过高是独立的,与手术后感染的风险增加1.49倍相关 (aOR: 1.49; 95% CI: 1.18-1.91).
- 大约2.7mmol/L的乳酸值峰值与更高的感染风险有关.
结论:
- 在手术期间的乳糖过高是心脏病发作后心脏手术中术后感染的独立危险因素.
- 针对在2.7mmol/L以下的手术内血乳酸水平,可能是降低手术后感染率的一种策略.
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