心脏手术后并发中枢神经系统感染的临床分析

目的：探讨心脏手术后并发中枢神经系统感染的发生率、死亡率、临床特征、死亡原因、危险因素以及防治方法。方法：分析10 173例心脏手术后各种神经系统并发症的总发生率,统计分析心脏手术后并发中枢神经系统感染的发生率、死亡率和种类,并与对照组进行比较分析。结果：心脏手术后神经系并发症的总发生率为1．4％（146／10173）,其中脑血管病占59．6％（87／146）。手术后合并中枢神经系统感染7．5％（11／146）。术后中枢神经系统感染组手术中心肌血流阻断时间及体外循环转机时间明显长于对照组（P＜0．01）。神经系统并发症组死亡44例,其中手术后并发中枢神经系统感染11例中8例死亡,占死亡总数的18．2％（8／44）。结论：心脏手术后并发中枢神经系统感染与手术中心肌血流阻断时间和体外循环转机时间过长有关,并且死亡率极高。

Central nervous system infection complicated after cardiac surgery,a clinical analysis of 10 173 cases

OBJECTIVE: To assess the morbidity, mortality, clinical features, death causes, prevention and treatment of patients with central nervous system infection(CNSI) undergoing cardiopulmonary bypass (CPB) surgery. METHODS: 10 173 cases of CNSI undergoing CPB surgery 1984 approximately 1997 were reviewed retrospectively to analysed the morbidity, mortality, clinical features, death causes, prevention and treatment of patients with CNSI after CPB surgery. RESULTS: After CPB surgery, the general morbidity of neurological complications (NC) was 1.4% (146/10 173), of which cerebrovascular diseases accounted for 59.6% (87/146), and CNSI 7.53%(11/146). The aortic clump time and CPB time were significantly longer in the CNSI group than in the controls (P < 0.01). Death occurred in 44 patients of the NC group, in which CNSI accounted for 18.2%(8/44). CONCLUSION: Postoperative CNSI correlates with longer aortic clump time and CPB time during the operation, and high mortality in CNSI group.