骨骼化与非骨骼化技术获取双侧乳内动脉导致术后胸骨感染的差异分析  

The Probability of Sternal Wound Infection between with or without a Skeletonization Technique Using Bilateral Internal Mammary Artery after Coronary Artery Bypass Graft

作　　者：荆朝辉[1] 荣晓松[1] 李明秋[1] 

机构地区：[1]南京医科大学附属无锡市人民医院心脏外科,江苏省无锡市214023

出　　处：《医学理论与实践》2018年第2期157-159,共3页The Journal of Medical Theory and Practice

摘　　要：目的:探究骨骼化与非骨骼化获取双侧乳内动脉技术在冠状动脉旁路移植术中对于术后胸骨感染率的影响。方法:收集了单中心共321例采取双侧乳内动脉作桥血管的冠状动脉旁路移植手术患者资料。根据动脉桥血管获取技术的不同,分为骨骼化组与非骨骼化组。结合文献,对潜在的导致术后胸骨感染的因素进行了单因素分析。并在控制已知可导致感染的单因素后,对两种获取技术是否导致术后胸骨感染进行了多因素分析。结果:术后骨骼化组有1例胸骨感染,非骨骼化组有5例胸骨感染。单因素分析提示术前体重指数过大、合并2型糖尿病、合并周围血管病、女性患者与术后胸骨感染相关。Logistic多因素分析提示骨骼化获取动脉技术能够明显降低术后胸骨感染率。结论:冠状动脉旁路移植术中,采用骨骼化技术采取双侧乳内动脉作桥血管,可减少术后胸骨感染的发病率。此结论在2型糖尿病患者中尤为明显。Objective:To explore the postoperative sternal infection probability between using skeletonized bilateral internal mammary artery or pedicled bilateral internal mammary artery after coronary artery bypass grafting.Methods:Demographics and outcomes were recorded from patients undergoing coronary bypass graft surgery with bilateral internal mammary artery using either skeletonized(n=128)or nonskeletonized(n=178)techniques.The primary outcome was total infection.Univariable and multivariable analysis was performed to determine the effect of skeletonization in the total group.Results:Univariable analysis indicate that with a higher body mass index,a diabetes mellitus history,a vascular disease history or a higher proportion of women are linked with a high incidence of postoperative sternal infection.Ultimately there was 1 infection in skeletonized group while 5 in the non-skeletonized group.Mutilvariable analysis confirmed that skeletonization was protective.Conclusion:Skeletonization is associated with a significant protective effect with regard to sternal infection after coronary artery bypass graft surgery with bilateral internal mammary artery.

关 键 词：冠状动脉旁路移植术 胸骨感染 乳内动脉 

分 类 号：R654.2[医药卫生—外科学]