【.】評論

關於縱膈腔的敘述，下列敘述何者錯誤?(A) 下行性壞死性縱膈腔炎大多數與口腔咽喉之感染有關正確。下行性壞死性縱膈腔炎主要是由於口腔或咽喉部位的感染沿著筋膜間隙向下擴散到縱膈腔所引起的。(B) 食道破裂是最常見的原因是醫源性造成正確。食道破裂的常見原因中，醫源性的如內窺鏡操作等，確實是一個主要的原因。(C) 胸骨切開手術術後早期感染危險因子包括糖尿病及二次胸骨切開手術，擷取內乳動脈非 危險因子這句描述的是胸骨切開手術後的感染危險因子。糖尿病和重複的手術確實都會增加感染的危險，擷取內乳動脈會影響感染風險(D) Fibrosing mediastinitis 的症狀主要來自縱膈腔器官組織的局限與壓迫正確。Fibrosing mediastinitis 是縱膈腔的纖維化病變，此疾病會導致縱膈腔組織纖維化和瘢痕形成，這些改變可能會壓迫縱膈腔內的器官，導致相關的症狀。Risk factors for the development of mediastinitis after cardiac surgery are:Diabetes Mellitus: This condition is known to impair wound healing and increases susceptibility to infections due to compromised immunity and microvascular changes.Obesity: Excess fat tissue can reduce blood flow, making it harder for the body to deliver cells responsible for healing to the surgical site. Moreover, obesity is associated with other comorbidities that can increase susceptibility to infections.Use of Internal Mammary Arteries: Especially if the use is bilateral. Harvesting these arteries can reduce the blood supply to the sternum, leading to decreased healing and increased risk of infection.Prolonged Operation: A longer operative time increases the period of exposure to potential sources of infection and can be a surrogate marker for the complexity of the procedure.Postoperative ICU Stay Exceeding 5 Days or Ventilation Exceeding 48 Hours: Longer ICU stays or extended ventilation might indicate post-operative complications or a more severe initial condition, both of which can contribute to a higher risk of mediastinitis.Need for Reexploration: Returning to the operating room may mean there were complications or issues with the initial surgery, increasing the risk of infections including mediastinitis.Assist Device Implantation: Implantation of any foreign body can act as a nidus for infection. Also, the complexity of these surgeries and the related postoperative care can increase the risk of complications including infection.Hence, based on your statement, the option (C) "胸骨切開手術術後早期感染危險因子包括糖尿病及二次胸骨切開手術，擷取內乳動脈非 危險因子" would be incorrect as it suggests that the harvesting of the internal mammary artery is not a risk factor.