体外循环术后12例胸骨裂开的诊断与处理

Diagnosis and Treatment of Sternal Rupture on 12 Cases After Extracorporeal Circulation

【目的】了解胸骨裂开的早期表现、诊断及治疗的要点。【方法】对近 10年 12例胸骨裂开病例进行回顾性分析与总结。【结果】 12例胸骨裂开的病例经过积极治疗 ,10例痊愈 ,2例死亡。伤口渗血增多、呼吸改变可能为胸骨裂开早期表现 ,治疗时改进缝合方法和胸骨后冲洗 ,积极治疗伴发病与并发症能提高治愈率。【结论】术中改进缝合技术 ,术后防止并发症可能降低胸骨裂开的发生率 ,及早发现与正确的术中和术后处理是治疗胸骨裂开的关键。

Objective To study the causes, early symptoms and the keys of diagnosis and treatment of sternal rupture. Methods 12 cases with sternal rupture in the last ten years were analyzed and summarized retrospectively. Results Among 12 sternal rupture cases, 10 cases were cured with positive treatment; two were died. Increasing bleeding on wounds and changing in breathing might be common early manifestations of sternal rupture. To improve the method of suture, wash behind the sternum and treat actively on the accompanying diseases and complications would increase the cure rate of sternal rupture. Conclusions To improve the technique of suture in operation and to prevent the complications after extracorporeal circulation may reduce the rate of sternal rupture. The keys of sternal rupture treatment are early discovery and correctly treatment during and after extracorporeal circulation.