医用生物蛋白胶在骨质疏松患者冠状动脉搭桥手术中的应用

Application of bioglue during coronary artery bypass grafting in patients with osteoporosis

目的:观察医用生物蛋白胶抑制严重骨质疏松患者正中开胸出血和胸骨切口感染裂开的疗效。方法:58例体外循环下正中开胸心脏不停跳冠状动脉搭桥手术的严重骨质疏松患者,随机分成医用生物蛋白胶组和对照组。医用生物蛋白胶组胸骨创面骨髓腔内喷涂及注射生物蛋白胶,对照组常规涂抹医用骨蜡,记录两组术后1d引流量及总引流量、引流液血红蛋白含量、拔引流管时间、切口拆线时间、术后持续发热时间及平均住院时间、术后胸骨切口愈合情况。结果:两组术后1d引流量和总引流量、引流液血红蛋白含量、拔引流管时间及平均住院时间有统计学差异(P<0.05),医用生物蛋白胶组明显减少。两组术后持续发热时间、切口拆线时间、术后胸骨感染裂开情况无明显差异。结论:医用生物蛋白胶可用于严重骨质疏松患者体外循环下冠状动脉搭桥手术。

Objective： To study the effect of bioglue on the sternal bleeding and sternal wound infection and dehiscence after median sternotomy in patients with severe osteoporosis. Methods：Fifty-eight patients with severe osteoporosis who underwent median stemotomy during beating-heart coronary artery bypass grafting （CABG）under extracorporeal circulation were randomly divided into bioglue group and control group. The medullary cavity of the sternum was spread with bioglue in bioglue group and bone wax in control group. The drainage volume on the first day and total drainage volume, the hemoglobin content in the drainage, the duration of drainage, the time of suture removal, the duration of continuous fever,the mean duration of hospitalization,and the healing of the sternal wound were recorded. Restults：The drainage volume on the first day and total drainage volume, the hemoglobin content in the drainage,the duration of drainage, and the mean duration of hospitaliztion in bioglue group were significantly lower than those in control group （all P 〈 0.05 ）. There was no significant difference in the duration of continuous fever,the time of suture removal,and the healing of the sternal wound between these 2 groups. Conclusion：Bioglue can be used in patients with severe osteoporosis who undergo median stemotomy during CABG under extracorporeal circulation.