Nateghian Alireza, Taylor Geoffrey, Robinson Joan L
Department of Pediatrics, Iran University of Medical Sciences, Tehran.
Am J Infect Control. 2004 Nov;32(7):397-401. doi: 10.1016/j.ajic.2004.03.004.
The rate and risk factors for surgical site infections (SSIs) in pediatric cardiac patients have not been well delineated.
All patients aged <18 years who had open-heart surgery at the Stollery Children's Hospital in the 1998-2002 period were followed. A case-control study was performed to examine risk factors for SSI. Controls were matched to cases according to National Nosocomial Surveillance System risk scores, age, and year of surgery.
SSI incidence was 3.4% (0.9% superficial wound infections, .1% deep incisional surgical site infections, and 2.4% organ space surgical site infections). In the case-control study, the only risk factor that was statistically significant was the duration of surgery. There was a trend toward an increased incidence of SSI (P < .25) for children with failure to thrive, or for those who required inotropes or had an elevated serum lactate in the first 24 hours postoperation.
In pediatric cardiac surgery, the risk of SSI increases with the duration of surgery. There is a need for prospective studies of potentially modifiable risk factors.
小儿心脏手术患者手术部位感染（SSI）的发生率及危险因素尚未得到明确界定。
对1998 - 2002年期间在斯托里儿童医院接受心脏直视手术的所有18岁以下患者进行随访。开展一项病例对照研究以检查SSI的危险因素。根据国家医院感染监测系统风险评分、年龄和手术年份将对照与病例进行匹配。
SSI发生率为3.4%（浅表伤口感染0.9%，深部切口手术部位感染0.1%，器官间隙手术部位感染2.4%）。在病例对照研究中，唯一具有统计学意义的危险因素是手术时长。发育不良的儿童、术后最初24小时内需要使用血管活性药物或血清乳酸水平升高的儿童，其SSI发生率有上升趋势（P < 0.25）。
在小儿心脏手术中，SSI风险随手术时长增加而升高。有必要对潜在可改变的危险因素进行前瞻性研究。
