Bogomolova N S, Abbakumov V V, Stepanenko R N, Potekhina A D, Pkhakadze T Ia, Vinogradova L N
Khirurgiia (Mosk). 1993 Feb(2):46-53.
Due to changes of humoral immunity, patients with rheumatic heart disease present, even before the operation, a high-risk group with regard to the development of infectious complications. Contamination of intraoperative material was revealed in 61.7% of cases during the operation. Extracorporeal circulation increases the cefotaxime half-life period which is in direct proportional dependence of the period of time between the beginning of the administration of the agent and the beginning of extracorporeal circulation. Immunocorrection by means of myelopid in the early postoperative period accelerates restoration of cellular and humoral immunity, and reduces the frequency of pneumonia occurrence and suppuration of the postoperative wound. Therefore, the prevention of infectious complications after operations on an open heart should be complex and should include broad-spectrum antibiotics and immunocorrective therapy.
由于体液免疫的变化，风湿性心脏病患者即使在手术前也是发生感染性并发症的高危人群。手术过程中61.7%的病例出现术中材料污染。体外循环会增加头孢噻肟的半衰期，这与药物开始给药至体外循环开始之间的时间呈直接比例关系。术后早期通过髓吡酮进行免疫纠正可加速细胞免疫和体液免疫的恢复，并降低肺炎的发生率和术后伤口化脓的频率。因此，心脏直视手术后感染性并发症的预防应是综合性的，应包括使用广谱抗生素和免疫纠正治疗。
