延迟关胸对小儿心脏术后伤口清创发生率的影响

Effect of Delayed Sternal Closure on Sternal Wound Debridement after Pediatric Cardiac Surgery

目的探索延迟关胸在小儿心脏外科术后的应用及对胸骨正中伤口清创术发生率的影响。方法回顾性分析2009年6月1日至2014年6月30日广东省人民医院491例延迟关胸患者的临床资料,其中男333例、女158例,年龄1 d至153.37个月(5.68±17.24)个月;比较延迟关胸患者和非延迟关胸患者清创术发生率的差异。结果 454例患儿术毕延迟关胸,37例ICU紧急床边开胸后延迟关胸。延迟关胸患儿中392例痊愈出院,8例患儿因家庭原因自动出院,91例死亡。延迟关胸患者中伤口清创术发生率高于非延迟关胸患者(χ2=6.693,P=0.010)。结论延迟关胸是重症心脏手术患儿是一种有效的治疗措施,但会提高胸骨正中伤口清创术的发生率。

Objective To investigate the effect of delayed sternal closure(DSC) on sternal wound debridement after pediatric cardiac surgery.Methods We retrospectively analyzed clinical data of 491 pediatric patients underwent DSC in Guangdong General Hospital between June 2009 and June 2014.There were 333 males and 158 females with age of 1 day to 153.37(5.68±17.24) months.The rate of sternal wound debridement between the DSC patients and the nonDSC patients was compared.Results A total of 454 pediatric patients with DSC initiated in the operation room.And 37 patients with DSC initiated in intensive care unit after emergency sternotomy.A total of 392 patients with delayed sternal closure were discharged.Eight patients gave up treatment for family reasons and 91 patients died.Patients with DSC had higher incidence of sternal wound debridement than the patients with non-DSC did(χ2=6.693,P=0.010).Conclusion DSC is an effective treatment for children with severe cardiac surgery,while it causes higher incidence of sternal wound debridement.