Kabanov M Yu, Kryukov N A, Binienko M A, Kravtsova O S, Belikova M Ya, Sementsov K V
Hospital for War Veterans, Russia, St. Petersburg.
Mechnikov North-Western State Medical University, St. Petersburg, Russia.
Khirurgiia (Mosk). 2021(4):53-57. doi: 10.17116/hirurgia202104153.
The incidence of mediastinitis after median sternotomy makes up 1-3%. This complication results prolonged hospital-stay, significant increase in treatment cost and high mortality (up to 75%). Severe COVID-19 pneumonia is often manifested by coughing, that impairs sternum stability after osteosynthesis. Moreover, concomitant leukopenia increases the risk of mediastinitis. Viral pneumonia and mediastinitis are complicated by respiratory failure and mutually potentiate the negative effect. Negative pressure wound therapy (NPWT) with combined antibiotic therapy ensures a favorable outcome even in patients with postoperative mediastinitis and osteomyelitis combined with viral pneumonia.
正中开胸术后纵隔炎的发生率为1%-3%。这种并发症会导致住院时间延长、治疗成本大幅增加以及高死亡率（高达75%）。重症新型冠状病毒肺炎常表现为咳嗽，这会损害骨合成后胸骨的稳定性。此外，合并白细胞减少会增加纵隔炎的风险。病毒性肺炎和纵隔炎会并发呼吸衰竭，并相互增强负面影响。负压伤口治疗（NPWT）联合抗生素治疗即使对于术后纵隔炎、骨髓炎合并病毒性肺炎的患者也能确保良好的治疗效果。
