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SM ISO690:2012 PRISĂCARU, Ion, NIGOLEAN, Angela, MOSCALU, Vitalie, URECHE, Andrei, MANOLACHE, Gheorghe, ŢURCANU, Grigore, BARNACIUC, Sergiu, MOROZAN, Vladislav, ONICA, Ecaterina, BATRÎNAC, Aureliu. Mediastinita anterioară după operaţii pe cord deschis. In: Arta Medica , 2012, nr. 2(49), pp. 27-31. ISSN 1810-1852. |
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Arta Medica | ||||||
Numărul 2(49) / 2012 / ISSN 1810-1852 /ISSNe 1810-1879 | ||||||
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Pag. 27-31 | ||||||
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Scopul lucrării Mediastinita anterioara după operaţii pe cord este asociată cu o rată sporită a morbidităţii, care duce la mărirea costului mediu de spitalizare a acestui contingent de pacienţi. Scopul acestui studiu a fost de a determina predictorii anteriori de dezvoltare a mediastinitei pre-, intra-, şi postoperatorie. Metode În perioada anilor 2000 – 2012, in Centrul de Chirurgie cardiaca au suportat intervenţie chirurgicala pe cord 3134 pacienţi, dintre
care la 46 (1,46%) de pacienţi evoluţia postoperatorie s-a coplicat cu clinică de mediastinită 23 (0.73%) şi infectarea plăgii postoperatorii cu sau fără dehiscenţa sternului 23 (0.73%). Grupul de pacienţi a fost constituit din 31 (67,3%) bărbaţi şi 15(32,7%) femei, cu vârsta medie de 59 de ani . Preoperatoriu 21 (45%) din
ei erau obezi, 8 (17%) aveau diabet zaharat, 31 (67%) bronşită cronică obstructivă. Pentru By-pass aortocoronarian s-a folosit artera toracică internă unilateral (ATI) 21(45%) şi ATI bilateral la 2(4% ) pacienţi. Timpul intervenţiei chirurgicale a constituit, în mediu 345min. Transfuzii masive postoperatoriu au necesitat doar la 6(13%) pacienţi. Diagnosticul de mediastinita a fost stabilit la a 5- 17 zi postoperatoriu. Restabilirea integrităţii sternale cu aplicarea procedeului Robicsek s-a efectuat la 14(30%) pacienţi.
Decesul a fost înregistrat la un pacient 1(2,1%) a- 20 zi postoperator cauzat de mediastinită seropurulentă şi de insuficienţă poliorganică. La 4 pacienţi s-a dezvoltat osteomielită sternală, care a necesitat tratament de lungă durată (3-6 luni). Concluzia Studiul sugerează că ATI uni sau bilaterale , bronhopneumonia cronica obstructivă, Diabetul zaharat, obezitatea, transfuziile
masive, timpul îndelungat a operaţiei sunt predicatori importanţi de mediastinită. |
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Cerif XML Export
<?xml version='1.0' encoding='utf-8'?> <CERIF xmlns='urn:xmlns:org:eurocris:cerif-1.5-1' xsi:schemaLocation='urn:xmlns:org:eurocris:cerif-1.5-1 http://www.eurocris.org/Uploads/Web%20pages/CERIF-1.5/CERIF_1.5_1.xsd' xmlns:xsi='http://www.w3.org/2001/XMLSchema-instance' release='1.5' date='2012-10-07' sourceDatabase='Output Profile'> <cfResPubl> <cfResPublId>ibn-ResPubl-35306</cfResPublId> <cfResPublDate>2012-06-04</cfResPublDate> <cfVol>49</cfVol> <cfIssue>2</cfIssue> <cfStartPage>27</cfStartPage> <cfISSN>1810-1852</cfISSN> <cfURI>https://ibn.idsi.md/ro/vizualizare_articol/35306</cfURI> <cfTitle cfLangCode='RO' cfTrans='o'>Mediastinita anterioară după operaţii pe cord deschis</cfTitle> <cfAbstr cfLangCode='RO' cfTrans='o'>Scopul lucrării Mediastinita anterioara după operaţii pe cord este asociată cu o rată sporită a morbidităţii, care duce la mărirea costului mediu de spitalizare a acestui contingent de pacienţi. Scopul acestui studiu a fost de a determina predictorii anteriori de dezvoltare a mediastinitei pre-, intra-, şi postoperatorie. Metode În perioada anilor 2000 – 2012, in Centrul de Chirurgie cardiaca au suportat intervenţie chirurgicala pe cord 3134 pacienţi, dintre care la 46 (1,46%) de pacienţi evoluţia postoperatorie s-a coplicat cu clinică de mediastinită 23 (0.73%) şi infectarea plăgii postoperatorii cu sau fără dehiscenţa sternului 23 (0.73%). Grupul de pacienţi a fost constituit din 31 (67,3%) bărbaţi şi 15(32,7%) femei, cu vârsta medie de 59 de ani . Preoperatoriu 21 (45%) din ei erau obezi, 8 (17%) aveau diabet zaharat, 31 (67%) bronşită cronică obstructivă. Pentru By-pass aortocoronarian s-a folosit artera toracică internă unilateral (ATI) 21(45%) şi ATI bilateral la 2(4% ) pacienţi. Timpul intervenţiei chirurgicale a constituit, în mediu 345min. Transfuzii masive postoperatoriu au necesitat doar la 6(13%) pacienţi. Diagnosticul de mediastinita a fost stabilit la a 5- 17 zi postoperatoriu. Restabilirea integrităţii sternale cu aplicarea procedeului Robicsek s-a efectuat la 14(30%) pacienţi. Decesul a fost înregistrat la un pacient 1(2,1%) a- 20 zi postoperator cauzat de mediastinită seropurulentă şi de insuficienţă poliorganică. La 4 pacienţi s-a dezvoltat osteomielită sternală, care a necesitat tratament de lungă durată (3-6 luni). Concluzia Studiul sugerează că ATI uni sau bilaterale , bronhopneumonia cronica obstructivă, Diabetul zaharat, obezitatea, transfuziile masive, timpul îndelungat a operaţiei sunt predicatori importanţi de mediastinită.</cfAbstr> <cfAbstr cfLangCode='EN' cfTrans='o'>Background Mediastinitis is a serious complication of cardiac surgery. It has a significant socioeconomic impact and high morbidity. The purpose of this study was to determine pre-, intra-, and postoperative predictors of mediastinitis. Methods and results From 3134 consecutive pacients, which underwent cardiac surgery in 2000-2012 , forty-six patients (1.46%) developed postoperator mediastinitis 23 (0.73%) and postoperator wound infection with or without dehiscence of the sternum 23 (0.73%) In This group of pacients 31 were men (67,3%) and 15 women (32,7%) of average age 59 years. Preoperative 21 (45%) of them were obes, 8 (17%) suffered of diabetes mellitus and 31 (67%) of chronic obstructive pulmonary disease. As a Coronary Artery Bypass Graft in 21(45%) was used unilateral IMA, and in 2(4%) cases BIMA. The average duration of surgery was 345min. Massive transfusion after surgery was needed on six patients (13%). Diagnosis of Mediastenitis was established at the 5 - 17 days postoperatively. Restoration of sternal integrity with the Robicsek proceeding was performed in 14 (30%) patients. One patients dead at the 20th day after surgery due to mediastenitis and failure Multiple Organ System Dysfunctions. 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