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[1]王学军,王金淳,徐小平,等.术后胸骨骨髓炎外科治疗的探讨[J].医学研究与战创伤救治(原医学研究生学报),2012,14(06):504-506.
　WANG Xue-jun,WANG Jin-chun,XU Xiao-ping,et al.Surgical treatment of sternal osteomyelitis following thoracic surgery[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2012,14(06):504-506.
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术后胸骨骨髓炎外科治疗的探讨()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第14卷
期数:
2012年06期
页码:
504-506
栏目:
出版日期:
2012-11-20

文章信息/Info

Title:
Surgical treatment of sternal osteomyelitis following thoracic surgery
文章编号:
1672-271X(2012)06-0504-03
作者:
王学军1; 王金淳2; 徐小平2; 汪 雷2; 张 珩2; 才志刚2; 张绍明2
1.200335 上海，南京军区上海医疗保健中心；2.200052 上海，解放军455医院心胸外科
Author(s):
WANG Xue-jun1; WANG Jin-chun2; XU Xiao-ping2; WANG Lei2; ZHANG Heng2; CAI Zhi-gang2; ZHANG Shao-ming2.
1.Shanghai Health Care Center of Nanjing Military Command,Shanghai 200335,China；2.Department of Cardiothoracic Surgery,455 Hospital of PLA,Shanghai 200052,China
关键词:
胸部外科手术; 手术并发症; 胸骨; 骨髓炎; 个体化治疗
Keywords:
thoracic surgery;  complications of surgery;  sternum;  osteomyelitis;  individualized
分类号:
R681.21
DOI:
-
文献标志码:
A
摘要:
目的 探讨术后胸骨骨髓炎外科治疗方法及疗效。方法 回顾分析17例术后胸骨骨髓炎病例资料。根据患者创面的大小、感染的范围程度及纵隔固定情况，选择手术治疗15例，其中腹直肌带蒂肌皮瓣转移修复6例(其中1例行腹壁下动静脉与左侧乳内动静脉吻合术)，胸大肌肌瓣转移3例，胸大肌联合腹直肌瓣转移3例，中厚皮片植皮3例。长期换药2例。结果 手术患者围手术期无死亡，所有肌瓣及肌皮瓣均I期愈合，1例植皮术后发生局部坏死，经再次植皮后愈合。2例换药1年后伤口愈合。随访2～61个月，所有患者伤口均愈合良好，胸骨骨髓炎无复发，生活质量明显提高。结论 根据创面缺损和感染情况选择个体化外科治疗可以取得满意效果。患者感染局限、纵隔固定之后是行彻底清创及确定性修复手术的最佳时机。
Abstract:
Objective To explore the efficacy of surgical treatment for sternal osteomyelitis after thoracic surgery.Methods Data were reviewed in 17 patients with sternal osteomyelitis after thoracic surgery who were admitted in our hospital between December 2006 and December 2011.Of the 17 patients,15 patients received surgical treatment depending on the size of the wound defects,the extent and severity of infection,and mediastinal fixation,including pedicled rectus abdominis musculocutaneous flap transfer in 6 patients (including inferior epigastric vein and left internal mammary vein anastomosis in one patient),pectoralis major muscle flap transfer in 3 patients,pectoralis major muscle and rectus abdominis muscle flap transfer in 3 patients,and medium-thick skin flap grafting in 3 patients.The remaining two patients received long-term dressing change.Results No perioperative death occurred.All muscle flaps and myocutaneous flaps achieved stage I healing.Local necrosis occurred in one patient who received skin grafting,and the wound healed well after a second skin grafting.In the two patients who received long-term dressing change,the wounds healed in a year.Follow-ups of 2～61 months showed that all wounds healed well without recurrence,and the quality of life was improved significantly in all patients as compared with that before surgical treatment.Conclusion Individualized surgical treatment for sternal osteomyelitis after thoracic surgery depending on wound defects and infection can offer satisfactory outcomes.The optimal timing for thorough debridement and definite surgical repair is after the control of local infection and mediastinal fixation.

参考文献/References:

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备注/Memo

备注/Memo:
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更新日期/Last Update: 2012-11-20