Abu-Omar Yasir, Kocher Gregor J, Bosco Paolo, Barbero Cristina, Waller David, Gudbjartsson Tomas, Sousa-Uva Miguel, Licht Peter B, Dunning Joel, Schmid Ralph A, Cardillo Giuseppe
Department of Cardiothoracic Surgery, Papworth Hospital NHS Foundation Trust, Cambridge, UK
Division of General Thoracic Surgery, Bern University Hospital / Inselspital, Switzerland.
Eur J Cardiothorac Surg. 2017 Jan;51(1):10-29. doi: 10.1093/ejcts/ezw326.
Mediastinitis continues to be an important and life-threatening complication after median sternotomy despite advances in prevention and treatment strategies, with an incidence of 0.25-5%. It can also occur as extension of infection from adjacent structures such as the oesophagus, airways and lungs, or as descending necrotizing infection from the head and neck. In addition, there is a chronic form of 'chronic fibrosing mediastinitis' usually caused by granulomatous infections. In this expert consensus, the evidence for strategies for treatment and prevention of mediatinitis is reviewed in detail aiming at reducing the incidence and optimizing the management of this serious condition.
尽管在预防和治疗策略方面取得了进展,但纵隔炎仍然是正中开胸术后一种重要且危及生命的并发症,发病率为0.25%-5%。它也可作为邻近结构(如食管、气道和肺部)感染的蔓延而发生,或作为头颈部下行性坏死性感染而出现。此外,还有一种慢性形式的“慢性纤维性纵隔炎”,通常由肉芽肿性感染引起。在本专家共识中,详细回顾了纵隔炎治疗和预防策略的证据,旨在降低其发病率并优化对这一严重病症的管理。