冠心病搭桥术后胸骨裂开的防治(附5例报道)

Pfevention of sternal dehiscence after cabg(5cases report)

目的 探讨冠心病搭桥术后胸骨裂开及其合并感染的诊断、治疗和预防。方法 未感染者及时再手术重新固定,合并感染者及时彻底清创、有效引流、牢固固定。结果 本组治愈率100％,伤口愈合时间平均10天(7～14天),1例除外。二次术后平均拔除引流管时间7.4天(2～20天)。结论 伤口局部的症状、体征、全身表现和X线胸片对诊断和治疗有重要意义。早发现、早诊断,及时重新固定,合并感染者及时彻底清创、有效引流、牢固固定是治疗成功的关键,可以有效缩短住院时间。重视胸骨裂开的预防,可减少其发生率。

Objective:To explore the diagnosis,treatment and prevention of sternal dehiscence combined with sternal wound infection after coronary artery bypass grafting(CABG) . Methods: Reoperative sternal fixation was used for those without sternal wound infection, completely wound cleaning, effective drainage and well fixation were used for those with sternal wound infection.Results:The effective rase was 100% in our study.The average healing time was 10 days (7 - 14days) ,1 case exception.The average taking off drainage tube was 7.4 days (2 - 20days) .Conclusion:The local wound symptom, systemic signs, and chest X-ray play a important role in diagnosis and treatment. Early detection and diagnosis, reoperative sternal fixation ; completrly cleaning the wound, effective drainage, well fixation for those with sternal wound infection are key piont for successful treatment. It can significantly reduce the inhospital time. Pay attention to prevention can decrease the incideuce of sternal dehiscence.