体外膜肺氧合应用于心脏手术后支持治疗的医院感染分析  

Analysis of the factors related to nosocomial infection in patients with extracorporeal membrane oxygenation after cardiac surgery

作　　者：廖小卒[1] 李斌飞[1] 孙各琴 梅闯闯 李素芬 程周[1] 王立强 李建伟[1] 袁勇[1] LIAO Xiao-zu;LI Bin-fei;SUN Ge-qin;MEI Chuang-chuang;LI Su-fen;CHENG Zhou;WANG Li- qiang;LI Jian-wei;YUAN Yong(Department of Extracorporeal Membrane Oxygenation Laboratory, Zhongshan Hospital Affiliated to Sun Yat- sen University, Zhongshan, Guangdong 528403, China;Department of Clinical Laboratory Medicine Center;Zhongshan Hospital Affiliated to Sun Yat-sen University, Zhongshan, Guangdong 528403, China)

机构地区：[1]中山大学附属中山医院体外膜肺氧合研究室,广东中山528400 [2]中山大学附属中山医院检验医学中心,广东中山528400

出　　处：《岭南心血管病杂志》2018年第2期165-168,共4页South China Journal of Cardiovascular Diseases

基　　金：中山市科技计划项目(项目编号:2015B1123)

摘　　要：目的分析心脏外科术后患者行体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)辅助治疗后出现的医院获得性感染的相关因素。方法对中山市人民医院2012年12月至2015年8月心脏外科术后行ECMO辅助治疗患者的医院获得性感染资料进行回顾性分析。结果 74例患者中发生院内感染30例,感染率40.5%,分离病原菌38株,其中革兰阴性菌22株,占57.9%,革兰阳性菌15株,占39.5%,真菌1株,占2.6%,多重耐药菌株高度集中,以鲍曼不动杆菌和各类凝固酶阴性葡萄球菌为主;医院获得性感染与呼吸机辅助时间、重症监护病房(intensive care unit,ICU)滞留时间、ECMO支持时间、总住院时间相关,具有统计学意义(P<0.05)。结论心脏外科术后行ECMO辅助治疗继发感染与呼吸机辅助时间、ICU滞留时间、ECMO辅助时间、总住院时间有明显相关性,医院应对此作出相应的预防措施,减少ECMO继发感染的发生率。Objectives To analyze the factors related to nosocomial infection in post-cardiac surgery patientswith extracorporeal membrane oxygenation（ECMO）treatment（p CS-ECMO）. Methods Clinical data of p CS-ECMOpatients who obtained nosocomial infections（NI）were collected and analyzed retrospectively. Results Among the74p CS-ECMO patients,30 occurred NI,accounting for 40.5%;a total of 38 pathogens were isolated,including 22 strains of gram-negative bacteria（57.9%）,15 strains of gram-positive bacteria（39.5%）,and one fungus（2.6%）.Multi-drug-resistant strains were highly concentrated,among which acinetobacter baumannii and various coagulase-negative staphylococci were the main types;NI was related with mechanical ventilation duration,intensive care unit（ICU）residence,ECMO duration,and duration of hospital stay,the correlations were statistically significant（P〈0.05）. Conclusions There are significant correlations between the secondary infections of p CS-ECMO and mechani-cal ventilation duration,ICU residence,ECMO duration,and duration of hospital stay;therefore,administration andmanagement of the hospital should take appropriate and preventive measures to reduce incidence of ECMO-secondaryinfections.

关 键 词：体外膜肺氧合 心脏手术后 医院感染 

分 类 号：R654[医药卫生—外科学]