胸大肌肌瓣移植治疗心脏术后胸骨感染疗效分析

Efficacy analysis of pectoralis major muscle flap transplantation for sternal infection after cardiac surgery

目的探讨胸大肌肌瓣移植修复心脏术后胸骨感染的治疗效果。方法2014年1月至2017年12月39例患者采用胸大肌肌瓣移植修复心脏术后胸骨感染(治疗组),同期26例采用外科清创加封闭负压引流治疗(对照组)。比较两组住院时间、住院费用、手术次数、满意度及复发率等指标差异。结果同对照组比较,治疗组住院时间短[(18.1±3.8)天对(36.7±11.4)天],住院费用较少[(19429±4088)元对(33495±10712)元],手术次数较少[(1.1±0.3)次对(2.4±0.8)次],患者满意度较高(56.4%对30.8%),复发率较低(5.1%对26.9%),差异均有统计学意义(P<0.05)。结论胸大肌肌瓣移植修复心脏术后胸骨感染是一种有效的治疗手段。

Objective To investigate the therapeutic effect of pectoralis major muscle flap transplantation in thoracotomy patients with sternal infection. Methods From January 2014 to December 2017, the treatment group of 39 patients with thoracic bone infection after cardiac surgery was used pectoralis major muscle flap to close the wound, while 26 patients were treated by debridement and vacuum sealing drainagea at the same time as the control group. The hospitalization time, hospital costs, number of operations, satisfaction survey, and relapse rate were compared between the those. Results Compared with the control group, the treatment group has the benefit of shorter hospitalization time [(18.1±3.8)days vs.(36.7±11.4)days], less hospital costs [(19 429±4 088)yuan vs.(33 495±10 712)yuan], less number of operations[(1.1±0.3)times vs.(2.4±0.8)times], higher level of satisfaction(56.4% vs. 30.8%), lower relapse rate(5.1% vs. 26.9%), the differences are statistically significant(all P<0.05). Conclusion Thoracic reconstruction with pectoralis major muscle flap is an effective treatment for sternal infection in postcardiac surgery.