增强磁共振检查在开胸术后纵隔炎诊治中的应用

Analysis of the application of enhanced MRI guided sequential therapy in the treatment of post-sternotomy mediastinitis

目的探讨增强磁共振(MRI)检查在开胸术后纵隔炎诊治中的临床应用价值。方法收集2013年6月~2017年12月北京大学第一医院收治的30例开胸术后纵隔炎患者的临床资料,以2016年1月之后收治的15例作为研究组,在增强MRI检查指导下进行清除手术及创面负压治疗;将2016年1月之前收治的15例患者作为对照组,进行传统的经验性清创手术治疗。比较2组患者的手术次数及平均住院天数等指标。结果应用增强磁共振检查之后,开胸术后纵隔炎患者的平均手术次数分别为研究组2.8±0.8次,对照组3.6±1.0次(P=0.036);平均住院天数研究组38.4±10.1天,对照组50.4±15.3天,差异有统计学意义(P=0.028)。结论应用增强磁共振检查指导开胸术后纵隔炎患者的清创治疗可显著减少手术次数及住院天数,临床应用价值较高。

Objective To evaluate the clinial application value of enhanced MRI in the treatment of post-sternotomy mediastinitis.Methods The clinical data of 30 patients with post-sternotomy mediastinitis treated in Peking University First Hospital from June 2013 to December 2017 were collected.15 patients who were admitted after January 2016 were selected as the study group and underwent debridement and negative pressure wound therapy under the guidance of enhanced MRI.15 patients admitted before January 2016 were used as the control group for empirical debridement.Indicators such as the number of operations and average hospitalization days of the two groups were compared.Results The average number of operations in patients with post-sternotomy mediastinitis was 2.8±0.8 in the study group and 3.6±1.0 in the control group(P=0.036);The average length of stay in the study group was 38.4±10.1 days and the control group was 50.4±15.3 days(P=0.028).Conclusion Using enhanced MRI to guide the debridement of post-sternotomy mediastinitis can significantly reduce the number of operations and hospital stay,and has high clinical application value.