中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2015年
4期
378-381
,共4页
郭龙辉%张竞超%徐敬%王文义%吴立文%宋晓东
郭龍輝%張競超%徐敬%王文義%吳立文%宋曉東
곽룡휘%장경초%서경%왕문의%오립문%송효동
冠状动脉旁路移植术,非体外循环%钛%胸骨
冠狀動脈徬路移植術,非體外循環%鈦%胸骨
관상동맥방로이식술,비체외순배%태%흉골
Coronary artery bypass graft,off-pump%Titanium plate%Sternum
目的 研究钛板在老年人非体外循环冠状动脉旁路移植术胸骨固定中的作用.方法 接受非体外循环冠状动脉旁路移植术老年患者120例随机分为两组,其中对照组60例,术中采用单纯钢丝固定胸骨,实验组60例,采用钛板联合钢丝固定胸骨.观察并记录两组患者手术关胸时间、术后术口疼痛率、胸骨裂开率以及胸骨再固定术的发生率.结果 实验组术后术口疼痛率(11.7％,7/60)低于对照组(38.3％,23/60)(x2=11.378,P＜0.05);实验组的术后胸骨裂开发生率(3.3％,2/60)低于对照组(13.3％,8/60)(x2=3.927,P＜0.05);实验组胸骨再固定术的发生率(1.7％,1/60)低于对照组(11.7％,7/60)(x2=4.821,P＜0.05).实验组的关胸时间(39±5)min比对照组(30±2)min延长(x2=13.386,P＜0.05).结论 钛板联合钢丝固定胸骨增加了老年人非体外循环冠状动脉旁路移植术的关胸时间,但是比钢丝固定胸骨的稳定性增加,术口疼痛减轻,胸骨裂开率降低,从而降低了胸骨再固定的风险.
目的 研究鈦闆在老年人非體外循環冠狀動脈徬路移植術胸骨固定中的作用.方法 接受非體外循環冠狀動脈徬路移植術老年患者120例隨機分為兩組,其中對照組60例,術中採用單純鋼絲固定胸骨,實驗組60例,採用鈦闆聯閤鋼絲固定胸骨.觀察併記錄兩組患者手術關胸時間、術後術口疼痛率、胸骨裂開率以及胸骨再固定術的髮生率.結果 實驗組術後術口疼痛率(11.7％,7/60)低于對照組(38.3％,23/60)(x2=11.378,P＜0.05);實驗組的術後胸骨裂開髮生率(3.3％,2/60)低于對照組(13.3％,8/60)(x2=3.927,P＜0.05);實驗組胸骨再固定術的髮生率(1.7％,1/60)低于對照組(11.7％,7/60)(x2=4.821,P＜0.05).實驗組的關胸時間(39±5)min比對照組(30±2)min延長(x2=13.386,P＜0.05).結論 鈦闆聯閤鋼絲固定胸骨增加瞭老年人非體外循環冠狀動脈徬路移植術的關胸時間,但是比鋼絲固定胸骨的穩定性增加,術口疼痛減輕,胸骨裂開率降低,從而降低瞭胸骨再固定的風險.
목적 연구태판재노년인비체외순배관상동맥방로이식술흉골고정중적작용.방법 접수비체외순배관상동맥방로이식술노년환자120례수궤분위량조,기중대조조60례,술중채용단순강사고정흉골,실험조60례,채용태판연합강사고정흉골.관찰병기록량조환자수술관흉시간、술후술구동통솔、흉골렬개솔이급흉골재고정술적발생솔.결과 실험조술후술구동통솔(11.7％,7/60)저우대조조(38.3％,23/60)(x2=11.378,P＜0.05);실험조적술후흉골렬개발생솔(3.3％,2/60)저우대조조(13.3％,8/60)(x2=3.927,P＜0.05);실험조흉골재고정술적발생솔(1.7％,1/60)저우대조조(11.7％,7/60)(x2=4.821,P＜0.05).실험조적관흉시간(39±5)min비대조조(30±2)min연장(x2=13.386,P＜0.05).결론 태판연합강사고정흉골증가료노년인비체외순배관상동맥방로이식술적관흉시간,단시비강사고정흉골적은정성증가,술구동통감경,흉골렬개솔강저,종이강저료흉골재고정적풍험.
Objective To investigate the role of titanium plate fixation for sternum closure after off-pump coronary artery bypass grafting (OPCABG) in elderly patients.Methods A total of 120 elderly patients who accepted OPCABG were randomly divided into two groups.The control group (n =60) received wire to fix the sternum,and the experimental group (n=60) received titanium plate combined with wire to fix the sternum.The chest closure time,the rate of postoperative incision pain,the rate of sternal dehiscence and sternal re-fixation between two groups were observed and recorded.Results The rates of postoperative incision pain,sternal dehiscence,sternal re-fixation was lower in experimental group than in control group [11.7％(7/60) vs.38.3％(23/60),3.3％(7/60) vs.13.3％(8/60),1.7％(1/60) vs.11.7％(7/60),x2 =11.378,3.927,4.821 respectively all P＜0.05].The chest closure time was longer in experimental group than in control group [(39±5)min vs.(30±2) min,x2 =13.386,P＜0.05].Conclusions Titanium fixation plate combined with wire for sternum closure can increase the stability of sternum fixation,reduce the postoperative pain and sternal dehiscence,and then decrease the risk of sternal re-fixation,but delay sternal closure of OPCABG in the elderly.
