解放军医学院学报2024，Vol.45Issue(3)：245-251,7.DOI:10.12435/j.issn.2095-5227.2023.131
胸骨正中劈开入路心脏术后并发胸部切口感染危险因素的病例对照研究
Factors associated with sternal wound infection after open heart surgery via sternotomy:A case-control study
陈东升 1刘建超 2冯泽坤 3李双磊 4何添 5张广良 5梁纯 5陈犹白 5韩岩5
作者信息
- 1. 解放军医学院,北京 100853||解放军总医院第一医学中心整形修复科,北京 100853
- 2. 解放军总医院第一医学中心卫勤部信息科,北京 100853
- 3. 解放军总医院第一医学中心心脏大血管外科,北京 100853
- 4. 解放军总医院第六医学中心心血管病医学部成人心脏外科,北京 100037
- 5. 解放军总医院第一医学中心整形修复科,北京 100853
- 折叠
摘要
Abstract
Background Median sternotomy is a conventional approach for cardiac surgery,and patients undergoing this approach may develop sternal wound infection(SWI),which may bring heavy economic pressure and great psychological burden and pain to patients.Objective To explore the independent risk factors for SWI,so as to lower its incidence and take preventive measures.Methods A retrospective analysis was conducted on patients who underwent open heart surgery through the median sternotomy approach at Chinese PLA General Hospital from January 2011 to January 2021.Cases of SWI were screened and a 1:4 propensity matching was performed.Characteristic variables were screened by univariate Cox analysis and LASSO regression.After considering expert opinions,appropriate variables were selected for multivariate Cox regression analysis.Results Of the 5 471 cases,61 cases developed SWI within 180 days after thoracotomy,with a incidence rate of 1.11%,44 of whom were SSWI and 17 were DSWI.In the whole cohort of 305 patients,there were 21 males and 40 females in the case group,with a median age of 61 years,while in the control group,there were 110 males and 134 females,with a median age of 59 years.Multivariate Cox regression analysis showed that body mass index(HR[95%CI]:1.07[1.00-1.14],P=0.047),diabetes(HR[95%CI]:1.87[1.01-3.46],P=0.047),and myocardial infarction(HR[95%CI]:2.25[1.19-4.26],P=0.010)were independently associated with SWI.Conclusion We find that the independent risk factors for SWI are diabetes,increased body mass index,and myocardial infarction.These factors are thought to influence the development of SWI by disrupting wound healing process,impairing tissue repair and skin barrier integrity,and decreasing resistance to bacteria.关键词
胸部切口感染/伤口愈合/危险因素/前正中胸骨劈开术/心脏手术Key words
sternal wound infection/wound healing/risk factor/median sternotomy/open heart surgery分类
医药卫生引用本文复制引用
陈东升,刘建超,冯泽坤,李双磊,何添,张广良,梁纯,陈犹白,韩岩..胸骨正中劈开入路心脏术后并发胸部切口感染危险因素的病例对照研究[J].解放军医学院学报,2024,45(3):245-251,7.
