记忆合金材料胸骨固定器在预防心脏瓣膜置换术后胸骨哆开中的应用  

Application of memory alloy sternum fixator to prevent sternum split after cardiac valve replacement operation

作　　者：苏永超[1] 田作春[1] 林青 李才[1] 黄永善[1] SU Yongchao;TIAN Zuochun;LIN Qing;LI Cai;HUANG Yongshan(Department of Cardiothoracic Surgery,the Third People's Hospital of Hainan Province,Sanya 572000,China)

机构地区：[1]海南省第三人民医院心胸外科,海南三亚572000

出　　处：《中国医学物理学杂志》2018年第9期1104-1107,共4页Chinese Journal of Medical Physics

摘　　要：目的:探讨记忆合金材料胸骨固定器在预防正中开胸切口行心脏瓣膜置换手术术后胸骨哆开中的应用。方法:选取海南省第三人民医院2014年2月至2018年2月行胸骨正中切口下心脏瓣膜置换手术患者116例,分为记忆合金联合钢丝固定组(A组,60例)和单纯钢丝固定组(B组,56例)。观察比较两组病例手术时间、术后疼痛评分(数字评分法)、术后肺部感染发生率、术后呼吸机使用时间、术后胸骨哆开发生率。结果:A组无胸骨哆开,B组5例发生胸骨哆开,发生率8.93%,两者比较差异有统计学意义(P=0.02)。两组病例手术时间无统计学差异(P=0.439)。术后疼痛评分、肺部感染发生率、呼吸机使用时间,A组明显优于B组(P<0.05)。结论:记忆合金材料胸骨固定器能降低心脏瓣膜置换术后胸骨哆开发生率,在胸骨正中切口心脏瓣膜置换手术中,记忆合金胸骨固定器联合钢丝行胸骨固定是一种可靠的胸骨内固定方法。Objective To study the application of memory alloy sternum fixator(MASF)on the prevention of sternum split after cardiac valve replacement(CVR)through a midline sternotomy.Methods A total of 116 patients who were admitted to the Third People's Hospital of Hainan Province from February 2014 to February 2018 for CVR through a midline sternotomy were divided in two groups.Group A contained 60 patients who underwent CVR operation using the combination of MASF and steel wire,while group B included 56 cases solely using steel wire for fixation.The time of operation,pain score after operation(numeric rating scales),the incidence of postoperative pulmonary infection,ventilator-assisted breathing time after operation and the incidence of sternum split after operation were compared between two groups.Results No sternum split was found in group A,while the incidence of sternum split was 8.93%in group B(5 cases),with significant differences(P=0.02).No significant differences were found in the time of operation between the two groups(P=0.439).Pain score after operation,the incidence of postoperative pulmonary infection and ventilator-assisted breathing time after operation in group A were significantly higher than those in group B,with statistical differences(P<0.05).Conclusion MASF decreases the incidence of sternum split after CVR operation.The combination of MASF and steel wire after CVR through a midline sternotomy is a reliable method for sternum internal fixation.

关 键 词：记忆合金 胸骨固定器 心脏瓣膜置换手术 胸骨正中切口 胸骨哆开 

分 类 号：R619[医药卫生—外科学]