作者：伍光，马小龙，柳佳吉，郎利

单位：

1.北京市垂杨柳医院心脏外科2.首都医科大学附属北京安贞医院心脏外科

Units：

1.Department of Cardiac Surgery, Beijing Chuiyangliu Hospital, Beijing 100021, China 2.Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China

关键词：

心脏外科手术; 胸骨固定; 并发症;

Keywords：

Cardiac surgical procedures; Sternal fixation; Complications

CLC：

DOI：

10.12114/j.issn.1008-5971.2023.00.170

Funds：

摘要：

目的 探讨不同胸骨固定方法对心脏直视手术后胸骨相关并发症的影响。方法 选取2021年于北京市垂杨柳医院及首都医科大学附属北京安贞医院心外科行心脏直视手术的成年患者342例。根据不同胸骨固定方法将其分为单股钢丝固定组(n=25)、双股钢丝固定组(n=251)与“8”字钢丝固定组(n=66)。比较三组基线资料及患者术后胸骨相关并发症[包括胸骨哆开(或松动)、胸骨表面或深部感染]发生情况。结果 三组术后胸骨相关并发症发生率比较，差异有统计学意义(χ2=9.742,P=0.008)；单股钢丝固定组术后胸骨相关并发症发生率分别高于双股钢丝固定组、“8”字钢丝固定组(P<0.05)。结论 单股钢丝“8”字缝合或双股钢丝间断缝合较单股钢丝间断缝合固定胸骨可减少心脏直视手术后胸骨哆开等相关并发症的发生。

Abstract：

Objective To investigate the influence of different sternal fixation methods on sternal complications after open heart surgery. Methods A total of 342 adult patients undergoing open heart surgery in the department of Cardiac Surgery of Beijing Chuiyangliu Hospital and Beijing Anzhen Hospital, Capital Medical University in 2021 were selected. According to different sternal fixation methods, they were divided into single wire fixation group (n=25) , double wire fixation group (n=251) and "8" wire fixation group (n=66) . The baseline data and the incidence of postoperative sternal complications [including open (or loose) sternal bone, surface or deep sternal infection] were compared among the three groups. Results There was significant difference in the incidence of sternal complications among the three groups (χ2 =9.742, P=0.008) . The incidence of postoperative sternal complications in the single strand wire fixation group was higher than that in the double strand wire fixation group and the "8" wire fixation group, respectively (P < 0.05) . Conclusion Single strand wire "8" suture or double strand wire interrupted suture can reduce the incidence of sternal dorsification and other related complications after open heart surgery.

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