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目的对小儿心脏手术胸骨闭锁过程中使用可吸收胸骨钉的疗效进行研究,证实其临床价值,为临床应用提供参考。方法以中山市人民医院2009年1月至2011年9月行小儿劈胸心脏手术的患者112例为研究对象,对其临床病历进行回顾性分析。将患者随机分为两组,研究组患者使用可吸收胸骨钉加钢丝(或可吸收缝线)立体固定进行胸骨闭锁;对照组患者使用传统的钢丝(或可吸收缝线)进行胸骨闭锁治疗。对比两组患者手术近期及远期的切口和胸骨相关并发症的发生情况。结果各种不同程度的切口及胸骨相关并发症共28例,其中研究组9例,对照组19例,研究组的胸骨及切口相关并发症发生率较对照组低,(P=0.026)。在所有并发症中,研究组患儿远期胸廓畸形的发生率明显较对照组低。结论小儿心脏手术过程中使用可吸收胸骨钉加钢丝(或可吸收缝线)立体固定进行胸骨闭锁疗效显著,并发症发生率低,适于临床推广使用。
Objective To study the curative effect of resorbable sternal nail in the process of sternal atresia in pediatric cardiac surgery, and to confirm its clinical value and provide reference for clinical application. Methods A total of 112 patients undergoing pedicle cardiothoracic surgery in Zhongshan People’s Hospital from January 2009 to September 2011 were studied retrospectively. The patients were randomly divided into two groups. Patients in the study group received sternal locking with absorbable sternal nail plus steel wire (or resorbable suture). Patients in the control group were treated with sternal atresia by traditional wire (or absorbable suture). The incidence of incision and sternal-related complications in both groups were compared between the two groups. Results There were 28 incisions of various incision and sternal complications, including 9 in the study group and 19 in the control group. The incidence of sternal and incision-related complications in the study group was lower than that in the control group (P = 0.026). Among all the complications, the incidence of long-term thoracic deformity in study group was significantly lower than that in control group. Conclusion The treatment of pediatric cardiac surgery using absorbable sternal nail plus steel wire (or absorbable suture) stereotactic sternal closure significant effect, the incidence of complications is low, suitable for clinical use.