胸骨结扎带联合钢丝在行胸骨劈开心脏手术患者胸骨固定中的应用效果  

Application effect of sternal ligation band combined with steel wire in sternal fixation of patients after sternal splitting heart surgery

作　　者：薛世岳 刘凡昭 杨根荣 刘雷 仝国林 XUE Shiyue;LIU Fanzhao;YANG Genrong;LIU Lei;TONG Guolin(Department of Cardiothoracic Surgery,the First Affiliated Hospital of Henan University of TCM,Zhengzhou 450000,Henan Province,China)

机构地区：[1]河南中医药大学第一附属医院心胸外科,河南郑州450000

出　　处：《新乡医学院学报》2022年第2期170-172,176,共4页Journal of Xinxiang Medical University

摘　　要：目的探讨胸骨结扎带联合钢丝在行胸骨劈开心脏手术患者胸骨固定中的应用效果。方法选择2019年1月至2020年9月在河南中医药大学第一附属医院心胸外科行胸骨劈开手术的心脏疾病患者46例为研究对象。依据固定胸骨的材料分为观察组(n=18)和对照组(n=28),观察组患者采用胸骨结扎带联合钢丝进行胸骨固定,对照组患者采用钢丝进行胸骨固定。比较2组患者胸骨固定时间、胸骨固定过程中出血量、术后疼痛视觉模拟评分、切口并发症等临床指标。结果观察组和对照组患者胸骨固定时间分别为(12.2±2.1)、(20.8±4.1)min,观察组患者胸骨固定时间显著短于对照组(t=-9.391,P<0.05)。观察组和对照组患者胸骨固定过程出血量分别为(92.2±20.3)、(130.5±39.1)mL,观察组患者胸骨固定过程出血量显著少于对照组(t=-3.934,P<0.05)。观察组和对照组患者术后疼痛视觉模拟评分分别为(2.6±0.9)、(4.6±1.2)分,观察组患者术后疼痛视觉模拟评分显著低于对照组,差异有统计学意义(t=-8.904,P<0.05)。2组患者均未出现胸骨哆开、纵隔感染等并发症。结论胸骨结扎带联合钢丝对胸骨的固定稳定性好,操作简单,安全,可显著缩短胸骨固定时间,减少胸骨固定过程中的出血量,减轻术后疼痛,且相关并发症少,切口美观。Objective To investigate the effect of sternal ligation band combined with steel wire in sternal fixation of patients after sternal splitting heart surgery.Methods Forty-six patients who underwent thoracotomy in the Department of Cardiothoracic Surgery,the First Affiliated Hospital of Henan University of TCM from January 2019 to September 2020 were selected as the research subjects.The patients were divided into observation group(n=18)and control group(n=28)according to the sternal fixation materials.The sternum of patients in the observation group were fixed with sternum ligation band combined with steel wire,and the sternum of patients in the control group were fixed with steel wire.The time of sternum fixation,the amount of blood loss during sternum fixation,visual analogue score of postoperative pain,incision complications and other clinical indexes were compared between the two groups.Results The sternal fixation time of patients in the observation group and the control group was(12.2±2.1),(20.8±4.1)min,the sternal fixation time of patients in the observation group was significantly shorter than that in the control group(t=-9.391,P<0.05).The amount of blood loss during sternum fixation of patients in the observation group and the control group was(92.2±20.3),(130.5±39.1)mL,the amount of blood loss during sternum fixation of patients in the observation group was significantly less than that in the control group(t=-3.934,P<0.05).The visual analog score of postoperative pain of patients in the observation group and the control group was 2.6±0.9,4.6±1.2,the visual analog score of postoperative pain of patients in the observation group was significantly lower than that in the control group(t=-8.904,P<0.05).No complications such as open sternum and mediastinal infection occurred in the two groups.Conclusion The sternal ligation band combined with steel wire has good stability in sternal fixation,and it is simple and safe;which can significantly shorten the time of sternal fixation,reduce the bleeding during

关 键 词：心脏手术 胸骨劈开 胸骨固定 结扎带 

分 类 号：R654.2[医药卫生—外科学]