医学课件 感染--【汉魅HanMei―医学专区分享】.ppt

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1、SurgicalInfectionTengChangshengDept.ofgeneralsurgeryBeijingFriendshipHospitalAffiliatedtoCapitalUniversityofMedicalSciencesGENERALCONSIDERATIONSSurgicalinfectionscanbedefinedasinfectionsthatrequireoperativetreatmentorresultfromoperativetreatment.Infections

2、thatrequireoperativetreatment1.necrotizingsofttissueinfection2.bodycavityinfection3.confinedtissue,organ,andjointinfection4.prostheticdevice-associatedinfectionsClassificationofSurgeryInfection一accordingtopathogenicbacterial:1.Nonspecificinfectionstaphylo

3、coccusaureus，StreptococcusEscherichiacoli，Bacillusproteus，pseudomon.2.Specificinfection二accordingtopathogenicprocess1.Acuteinfection2.Chronicinfection3.SubacuteinfectionInfectionsthatresultfromoperativetreatmentinclude:1.woundinfection,2.postoperativeab

4、scess3.postoperativeperitonitis4.postoperativebodycavityinfections5.hospital-acquiredinfection(resultfromthetransmissionofpathogensfromasourceinthehospitalenvironmenttoapreviouslyuninfectedpatient)suchaspneumonias,urinarytractinfection.DeterminantsofInfect

5、ionThedevelopmentofsurgicalinfectiondependsonseveralfactors:1.Microbialpathogenicity2.Hostdefenses,3.Thelocalenvironment4.SurgicaltechniqueMicrobialPathogenicity1.Thickcapsules2.Resistdigestionbylysosomalenzymes.3.Elaboratetoxins:endotoxins,neurotoxinsHos

6、tDefensesLocalHostDefenses.1.Epithelium.2.Localenvironmentisnotconducivetomicrobialattachmentandgrowth.SystemicHostDefensesHostdefenses:Phagocyticcells:polymorpho-nuclearleukocytes(PMNs)tissuemacrophages.ImmunesystemMolecularcascades.Theinitiationofthispro

7、cessanditsattendantchemical,cellular,andphysiologicchangesresultsininflammation.LocalEnvironmentalFactorsLocalenvironmentalfactorsinhibitsystemichostdefensesfrombeingfullyeffective:DevitalizationoftissueForeignbodiesDiagnosisDiagnosisofsurgicalinfectionsho

8、uldbeaccordedtoclinicalexaminationandlaboratoryexamination.ClinicalExamination1.Systemicsymptoms:FeverandChillsElevatedpulserate2.Endemicsignsandsymptoms:RednessSwellingHeatPainLossoffunction.3.shock,dysfunct