心脏术后胸骨剁开的治疗及预防

Treatment and prevention of unstable sternum after cardiac surgery

目的：探讨心脏术后胸骨剁开的治疗及预防。方法回顾性分析2012年7月1日至2013年9月30日在郑州大学第一附属医院接受胸骨正中切口心脏手术治疗后发生胸骨剁开的30例患者的诊治经过，探讨其治疗方法及预防措施。结果本研究患者心脏术后胸骨剁开的发生率为3.75%，均采用胸骨梯形固定，纵隔清创冲洗引流，术后采用冲洗法治疗，并辅以全身抗感染及必要的营养支持，改善心功能，无术后早期死亡。结论尽早确诊，及时采用胸骨固定加纵膈清创冲洗引流术，加强术后冲洗、全身抗感染治疗及营养支持是治疗预防心脏手术后胸骨剁开的有效方法。

Objective To investigate the treatment and prevention methods of unstable sternum after cardiac surgery. Methods A retrospective analysis of the diagnosis and treatment of 30 patients with unstable sternum caused by cardiac surgery through median sternotomp from 1st July 2012 to 30th September 2013 at the First Affiliated Hospital of Zheng-zhou University was made,and the treatment and preventive measures were investigated. Results The postoperative unstable sternum rate was 3. 75%,with sternal ladder-type fixation,mediastinum debridement,irrigation and drainage,surgery in the lavage treatment,supplemented by systemic anti infection and the necessary nutrition,the heart function was improved,there was no mortality in early postoperative period. Conclusions Early diagnosis,mediastinum debridement irrigation after systemic anti infection and nutrition support is effective treatment method for infection of mediastinum after open heart surgery.