胸部正中切口心脏手术后化脓性肋软骨炎诊治体会  

Experiences in the diagnosis and treatment of suppurative costal chondritis after cardiac surgery through midline chest incision

作　　者：张晓明[1] 董永强[1] 殷桂林[1] 朱水波[1] 王荣平[1] 纪涛[1] 徐家行[1] 

机构地区：[1]广州军区武汉总医院心胸外科

出　　处：《临床外科杂志》2015年第8期604-605,共2页Journal of Clinical Surgery

摘　　要：目的探讨胸骨正中切口心脏手术后化脓性肋软骨炎的诊断及治疗方案。方法对我院收治的8例确诊为胸部正中切口心脏手术后发生化脓性肋软骨炎并行彻底清创术的患者进行回顾性分析。结果8例患者经清创处理后，伤口全部Ⅰ期愈合，疼痛症状消失，无胸壁软化症状。随访6个月～4年，未见肋软骨炎复发。结论根据化脓性肋软骨炎患者行胸骨正中切口开胸手术病史，明确的局部剧烈胸痛，以及局部B超或胸部CT检查可明确诊断。手术彻底清除病变的肋软骨和其他坏死组织是有效的治疗方法之一。Objective To explore the diagnosis and treatment of suppurative costal chondritis after cardiac surgery through median sternotomy. Methods The clinical data of eight patients with suppurative costal chondritis after cardiac surgery and following debridement in our hospital were analyzed retrospectively. Results All wounds in eight patients healed primarily after the debridement. The patients were followed up for six months to four years and no signs of costal chondritis occurred. Conclusion The diagnosis of costal chondritis should be considered when patients have typical chest pain after cardiac surgery through midline chest incision. Highbaumanniifrequency ultrasonography and spiral CT scan were the useful methods for diagnosis and localization of costal chondritis for these patients. Thorough excision of the necrotic costal cartilages and tissues is one of the effective methods for the treatment of costal chondritis after cardiac surgery.

关 键 词：肋软骨炎 胸部正中切口 高频超声 螺旋CT 

分 类 号：R654.2[医药卫生—外科学]