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计算机断层扫描在胸骨伤口感染中的应用:系统评价。

Computed Tomography Scanning for Sternal Wound Infections: A Systematic Review.

机构信息

School of Medicine, Queen's University Belfast, School of Medicine, Belfast, UK.

Barts and the London School of Medicine, QMUL.

出版信息

Ulster Med J. 2024 Jan;92(3):139-147. Epub 2024 Jan 29.

Abstract

BACKGROUND

Sternal wound infection (SWI) has always been a significant risk in patients who undergo sternotomies as part of their cardiac surgical procedures. Computed tomography (CT) imaging is often used to diagnose and assess sternal wound infections. Its purpose includes identifying and locating infection and any sternal dehiscence.

METHODS

A systematic literature review across PubMed, Embase, and Ovid was performed according to PRISMA guidelines to identify relevant articles that discussed the utility of CT scanning for SWI, common features identified, patient outcomes and sensitivity/specificity (Figure 1).

RESULTS

25 papers were included. 100% (n=25) of the papers were published in peer-reviewed journals. CT scans in SWIs can be seen as a beneficial aid in diagnosing as well as determining the components of infection. Commonalities were identified such as fluid collection in the mediastinum, free gas, pleural effusions, and sternal dehiscence which point towards the presence of sternal wound infection.

CONCLUSION

CT scanning is a novel and emerging methodology for imaging in SWI and post-sternotomy complications, hence increased research is required to expand the literature on this area as well as the creation of guidelines and cut-offs or signs for radiology professionals to identify and determine the extent of infection.

摘要

背景

胸骨切开术后感染(SWI)一直是接受心脏外科手术胸骨切开术患者的重大风险。计算机断层扫描(CT)成像常用于诊断和评估胸骨切开术后感染。其目的包括识别和定位感染和任何胸骨裂开。

方法

根据 PRISMA 指南,对 PubMed、Embase 和 Ovid 进行了系统的文献回顾,以确定讨论 CT 扫描对 SWI 的实用性、识别出的常见特征、患者结局以及敏感性/特异性的相关文章(图 1)。

结果

共纳入 25 篇论文。100%(n=25)的论文发表在同行评议的期刊上。SWI 中的 CT 扫描可作为诊断和确定感染成分的有益辅助手段。确定了一些共同点,如纵隔积液、游离气体、胸腔积液和胸骨裂开,这些都表明存在胸骨切开术后感染。

结论

CT 扫描是一种用于 SWI 和胸骨切开术后并发症成像的新颖且新兴的方法,因此需要更多的研究来扩展该领域的文献,并为放射科专业人员制定指南和截止值或标志,以识别和确定感染的程度。

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