围手术期给氧对手术部位感染影响的研究现状
Research Status of the Effect of Perioperative Oxygen on Surgical Site Infection
DOI: 10.12677/ACM.2022.124376, PDF,   
作者: 许吉涛, 龚向东：大理大学第一附属医院，云南 大理
关键词: 围手术期；吸氧；手术部位感染；Perioperative Period； Oxygen Inhalation； Surgical Site Infection
摘要: 手术部位感染(SSI)会使患者并发症、死亡率及医疗费用增加。CDC及WHO最新预防手术部位感染指南均推荐在术中及术后给予高浓度氧气以预防手术部位感染。伤口愈合的纤维增生、基质沉积、血管生成阶段都依赖氧气，伤口抗感染机制主要由非特异性免疫系统承担，对感染伤口的生物体的抵抗力几乎完全取决于吞噬细胞的杀菌能力，而吞噬细胞的杀伤能力主要由氧化杀伤系统构成，氧化杀伤严重依赖氧含量，低氧含量会抑制吞噬细胞氧化杀伤能力。在目前的围手术期给氧与预防手术部位感染仅仅在结直肠手术中显示出有一定的益处，但是CDC和WHO均推荐全麻插管病人，在术中及术后6小时高浓度吸氧以预防SSI的发生。这让我们对吸氧能否预防SSI的发生有了一定的质疑，为此我们对现有文献进行回顾及分析。
Abstract: Surgical site infection (SSI) is associated with increased complications, mortality and medical costs. The latest CDC and WHO guidelines for the prevention of SSI recommend high concentration of oxygen during and after surgery to prevent SSI. Wound healing of fiber hyperplasia, matrix deposition, stage of angiogenesis are dependent on the oxygen, anti-infection wound mechanism is mainly borne by the nonspecific immune system, the resistance of the organism to infection of the wound almost entirely on the sterilization ability, phagocytes and kill capability of phagocytes oxidative damage system structure, oxidative damage heavily dependent on oxygen content, low oxygen content can inhibit the oxidative killing ability of phagocytes. Currently, perioperative oxygen inhalation and prevention of surgical site infection have only been shown to be beneficial in colorectal surgery, but both CDC and WHO recommend highly concentrated oxygen inhalation during and 6 hours after general anesthesia for patients with intubation to prevent SSI. This led us to question whether oxygen inhalation could prevent the occurrence of SSI, so we reviewed and analyzed the existing literature.
文章引用：许吉涛, 龚向东. 围手术期给氧对手术部位感染影响的研究现状[J]. 临床医学进展, 2022, 12(4): 2616-2622. https://doi.org/10.12677/ACM.2022.124376

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