防损伤减张胸骨助闭钳的研制与临床应用

Development and clinical application of anti-injury and tension-assisted sternum closing forceps

目的探索一种运用新的手术器械在胸骨正中劈开手术后胸骨闭合中的应用方法并检验其效果。方法回顾性分析2019年1月至2022年6月新余市人民医院收治的43例心脏手术患者、26例胸腺肿瘤手术患者的临床资料,按照不同的胸骨闭合固定手术方法将其分为观察组(n=38)与和对照组(n=31)。观察组采用防损伤减张助闭钳闭合固定胸骨的方法,对照组采用传统方法闭合固定胸骨。比较两组患者的胸骨闭合固定时间、钢丝拧断率、术后患者疼痛视觉模拟评分、术后切口并发症发生率。结果观察组手术中平均胸骨闭合固定时间短于对照组,差异有统计学意义(P<0.05)。观察组手术中钢丝拧断率(2.52%)低于对照组(6.88%),差异有统计学意义(P<0.05)。观察组术后患者切口疼痛视觉模拟评分低于对照组,差异有统计学意义(P<0.05)。观察组术后切口并发症发生率(5.26%)低于对照组(22.58%),差异有统计学意义(P<0.05)。结论防损伤减张胸骨助闭钳设计科学合理,在应用于胸骨正中劈开手术后胸骨闭合固定中缩短了手术时间,具有固定力量持续稳定、操作简便安全、胸骨固定稳固无损伤、术后切口疼痛轻、并发症少等优势。

Objective To explore an application method of using a new surgical instrument in sternum closure after median sternotomy and to test its effect.Methods The clinical data of 43 patients undergoing cardiac surgery and 26 patients undergoing thymic tumor surgery in Xinyu People's Hospital from January 2019 to June 2022 were retrospectively analyzed,and they were divided into observation group(n=38)and control group(n=31)according to different sternal closure and fixation methods.In the observation group,the sternum was closed and fixed with anti-injury and tension-assisted closing forceps,in the control group,the sternum was closed and fixed with the traditional method.The time of sternal closure and fixation,the rate of wire twisting,the visual analogue scale of postoperative pain,and the incidence of postoperative incision complications were compared between the two groups.Results The average sternum closure and fixation time in the observation group was shorter than that in the control group,and the difference was statistically significant(P<0.05).The wire breakage rate(2.52%)in the observation group was lower than that in the control group(6.88%),and the difference was statistically significant(P<0.05).The visual analogue score of postoperative incision pain in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).The incidence of postoperative incision complications in the observation group(5.26%)was lower than that in the control group(22.58%),and the difference was statistically significant(P<0.05).Conclusion The design of anti-injury and tension-assisted sternum closing forceps is scientific and reasonable.It can shorten the operation time in the application of sternum closure and fixation after median sternotomy.It has the advantages of continuous and stable fixation force,simple and safe operation,stable sternum fixation without injury,less postoperative incision pain,and fewer complications.