应用TiNi环抱式接骨器防治心脏术后胸骨哆开的临床研究  

Clinical study on the use of TiNi encircling bone connector to prevent and treating sternal opening after cardiac surgery

作　　者：朱慎钰[1] 余小强 刘子由[1] 李树林[1] 熊健宪[3] ZHU Shen-yu;YU Xiao-qiang;LIU Zi-you;LI Shu-lin;XIONG Jian-xian(Department of Cardiothoracic Surgery,the First Affiliated Hospital of Gannan Medical College,Jiangxi Province,Ganzhou 341000,China;Department of Thoracic Surgery,Ruijin People′s Hospital,Jiangxi Province,Ruijin 341000,China;Department of Cardiovascular Surgery,the First Affiliated Hospital of Gannan Medical College,Jiangxi Province,Ganzhou 341000,China)

机构地区：[1]赣南医学院第一附属医院心胸外科,江西赣州341000 [2]江西省瑞金市人民医院胸外科,江西瑞金341000 [3]赣南医学院第一附属医院心脏大血管外科,江西赣州341000

出　　处：《中国当代医药》2021年第27期108-110,共3页China Modern Medicine

基　　金：江西省赣州市指导性科技计划项目(GZ2016ZSF011)。

摘　　要：目的探讨应用TiNi环抱式接骨器防治心脏术后胸骨哆开的临床价值。方法选择2018年6月至2020年10月在赣南医学院第一附属医院心胸外科行心脏手术治疗的90例患者,按随机数字表法将患者分为研究组(45例)和参考组(45例)。参考组术中用钢丝固定胸骨,研究组术中用TiNi环抱式接骨器固定胸骨。比较两组的手术相关指标、术后并发症发生情况。结果研究组的视觉模拟评分法(VAS)评分为(5.17±1.14)分,低于参考组的(7.65±1.08)分,差异有统计学意义(P<0.05);研究组的术后呼吸机使用时间为(18.34±4.54)h、重症加强护理病房(ICU)停留时间为(43.97±7.54)h、住院时间为(13.67±2.04)d,均短于参考组的(26.65±9.21)、(63.50±14.65)h、(19.86±3.24)d,差异有统计学意义(P<0.05);两组的手术时间比较,差异无统计学意义(P>0.05);研究组的术后并发症总发生率低于参考组,差异有统计学意义(P<0.05)。结论心脏手术中应用TiNi环抱式接骨器能够减轻患者术后疼痛,降低胸骨哆开、肺部感染发生,缩短术后呼吸机使用时间、ICU停留时间、住院时间,有助于患者早日康复。Objective To explore the clinical value of using TiNi encircling bone connector to prevent and treating sternal opening after cardiac surgery.Methods From June 2018 to October 2020,90 patients who were to undergo cardiac surgery in the Department of Cardiothoracic Surgery of the First Affiliated Hospital of Gannan Medical College were selected.The patients were divided into the study group(45 cases)and the reference group(45 cases)according to the random number table method.The reference group used steel wires to fix the sternum during the operation,and the study group used TiNi encircling bone connectors to fix the sternum during the operation.The surgery-related indicators,the occurrence of postoperative complications were compared between the two groups.Results The visual analogue scoring(VAS)score of the study group was(5.17±1.14)points,which was lower than the(7.65±1.08)points of the reference group,the difference was statistically significant(P<0.05).The postoperative ventilator use time of the study group was(18.34±4.54)h,and the intensive care ward(ICU)stay time of the study group was(43.97±7.54)h,hospitalization time of the study group was(13.67±2.04)d,which were shorter than those of the reference group([26.65±9.21],[63.50±14.65]h,[19.86±3.24]d),the differences were statistical significance(P<0.05).There was no significant difference in the operation time between the two groups(P>0.05).The total incidence of postoperative complications in the study group was lower than that in the reference group,and the difference was statistically significant(P<0.05).Conclusion The application of TiNi embracing bone connector in cardiac surgery can reduce postoperative pain,reduce the occurrence of sternal opening and lung infection,shorten the time of postoperative ventilator use,ICU stay,and hospital stay,and help patients recover quickly.

关 键 词：心脏手术 胸骨哆开 TiNi环抱式接骨器 钢丝 

分 类 号：R655.1[医药卫生—外科学]