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	延期胸骨闭合在心脏外科中的应用(附11例报告)
	奚吉成 ; 李宏伟 ; 李斌 ; XI Ji-cheng ; LI Hong-wei ; LI Bin
	2010-06-09 ; 2010-06-09
关键词	延期胸骨闭合 心脏外科手术 手术后并发症 delayed sternal closure cardiac surgical procedures postoperative complications R654.21
其他题名	Application of delayed sternal closure in cardiac surgery:a report of 11 cases
中文摘要	目的探讨延期胸骨闭合技术在心脏直视手术后的应用。方法2000年3月-2005年6月共11例心脏外科手术患者采用延期胸骨闭合技术,其中男4例,女7例,年龄16～67(42.4±15.8)岁。原因包括心脏扩大、顽固性心律失常、出血和严重肺水肿。在胸骨敞开期间用三层护皮膜粘贴覆盖伤口,当出血停止、心脏缩小及循环平稳后再实施关胸手术。结果本组2例患者延期关胸前死于肾功能衰竭,9例患者成功延期闭合胸骨。1例术后第21天死于心跳骤停,其余8例术后1～8d(3.9±2.4d)后转出ICU,并痊愈出院。随访3个月,心功能Ⅰ级4例,Ⅱ级2例,Ⅲ级2例。结论延期胸骨闭合能减轻心脏受压情况,且可以迅速探查纵隔,是处理心脏手术后心脏压塞、严重出血和心律失常的有效方法,且不会显著增加胸骨感染等相关并发症。; Objective To investigate the application of delayed sternal closure in the process of open heart surgery.Methods Delayed sternal closure was performed from Mar.2000 to Jun.2005 in 11 patients(4 males and 7 females,aged 16-67 years with an average of 42 years) after cardiac surgery.The indication included: cardiac dilatation(4 cases),intractable arrhythmia(4 cases),continuous bleeding(2 cases) and severe pulmonary edema(1 case).During the open chest period,the wound was covered with 3-layers of latex temporarily,and the delayed sternal closure was performed when bleeding was controlled,heart size reduced,and hemodynamic condition became stable.Results Except two patients died of acute kidney failure during open chest period,delayed sternal closure was successfully carried out in 9 patients 8-43 hours(23.7±11.0) after cardiac surgery.Except one patient died of cardiac arrest 21 days after operation,the 8 others survived and were discharged from ICU 1-8 days(3.9±2.4) after sternal closure,and the wounds healed well.Follow-up for the 8 survivors revealed an improvement of NYHA class(class Ⅰfor 4 cases,class Ⅱfor 2 cases,and class Ⅲ for 2 cases).Conclusion The delayed sternal closure is an effective method in the treatment of postoperative cardiac compression,severe bleeding and arrhythmia,and it does not increase the incidence of complications such as sternal infection.
语种	中文 ; 中文
内容类型	期刊论文
源URL	[http://hdl.handle.net/123456789/59114]
专题	清华大学
推荐引用方式 GB/T 7714	奚吉成,李宏伟,李斌,等. 延期胸骨闭合在心脏外科中的应用(附11例报告)[J],2010, 2010.
APA	奚吉成,李宏伟,李斌,XI Ji-cheng,LI Hong-wei,&LI Bin.(2010).延期胸骨闭合在心脏外科中的应用(附11例报告)..
MLA	奚吉成,et al."延期胸骨闭合在心脏外科中的应用(附11例报告)".(2010).

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