心脏直视手术胸骨正中切口胸骨固定闭合的策略探讨

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Abstract Objective To explore the personalized treatment strategy of sternal fixation and closure through median sternal incision in open heart surgery. Methods Patients who underwent open heart surgery with median sternal incision in Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from January 2019 to March 2021 were selected as the research objects. The characteristics of sternal fixation methods and chest incision complications were observed and analyzed retrospectively. Results Of the 293 patients, 169 cases were closed sternum with single steel wire fixation and 124 cases with double steel wire fixation. Robicsek braided sternum in 27 cases (19 cases with single steel wire and eight cases with double steel wire). Eight cases were fixed with sternal plate (five cases with single steel wire and three cases with double steel wire). Allogeneic cancellous bone sternum transplantation was performed in 40 cases (21 cases with single steel wire and 18 cases with double steel wire). Sternal instability occurred in five cases (four cases with single steel wire and one case with double steel wire). Superficial sternal wound infection in six cases (five cases with single steel wire and one case with double steel wire). Deep sternal wound infection in one case (one case with single steel wire and zero case with double steel wire). After active treatment of these complications, they were cured and discharged without related deaths. Conclusion Selecting the appropriate sternal fixation and closure method according to the characteristics of patients can reduce the incidence of sternal incision complications. A personalized selection strategy for sternal fixation and closure is proposed, which requires verification in clinical studies.

Key words： Sternal fixation Sternal wound infection Open heart surgery Median sternal incision

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	LIU Jianzhou MA Guotao LIU Xingrong LI Xiaofeng MIAO Qi ZHANG Chaoji

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LIU Jianzhou MA Guotao LIU Xingrong LI Xiaofeng MIAO Qi ZHANG Chaoji. Strategy discussion of sternal fixation and closure through median sternal incision in open heart surgery[J]. 中国医药导报, 2022, 19(20): 62-65,74.

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https://www.yiyaodaobao.com.cn/EN/ OR https://www.yiyaodaobao.com.cn/EN/Y2022/V19/I20/62

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