聚合物束帶於傳統胸骨切開縫合之應用分析

目的：本次研究通過對比分析胸骨束帶固定胸骨和鋼絲固定胸骨的心臟手術患者資料，以評估胸骨束帶固定的安全性及有效性。方法：50名於本院進行心臟手術的患者被分為兩組進行比較。在心臟手術後，胸骨縫合固定會按病患情況而選用聚醚醚酮束帶（ZipFix系統）25人與傳統鋼絲25人。胸骨縫合時間、術後疼痛及胸骨併發症會在兩組中進行比較分析。結果：胸骨縫合時間在聚醚醚酮束帶（ZipFix系統）組是10～15分鐘而在傳統鋼絲組是15～20分鐘。傳統鋼絲組中出現一例胸骨切割斷裂的併發症，而且聚合物束帶（ZipFix系統）組的平均疼痛指數在追蹤期間均低於傳統鋼絲。結論：在成人心臟手術後使用聚合物束帶（ZipFix系統）進行胸骨縫合是安全而有效的，同時可以有效地縮短胸骨縫合的時間及減低術後疼痛。

關鍵字

心臟手術；胸骨正中切開術；胸骨縫合； ZipFix系統

並列摘要

Objective: Midline sternotomy remains the most common access incision for cardiac operations. Traditionally, the sternum is closed with stainless steel wires. However, the sternum may be stretched and broken, leading to pain, nonunion, and potential deep sternal wound infection in the elderly patient. This study compared postoperative complications after sternotomy closure by polymer cable ties (Sternal ZipFix system, DePuy Synthes) and conventional steel wire . Methods: Fifty adult patients undergoing cardiac surgery were divided into two groups. After the surgery, the sternal closure was randomly done with a poly-ether-ether-ketone (PEEK) based sternal ZipFix system on the sternal body (n=25) or with conventional wires (n=25). Operation time of sternal closure, postoperative pain and complications of sternotomy were analyzed in two groups. Results: The operation time of sternal closure was 10 to 15 minutes in the ZipFix group and 10 to 20 minutes in the steel wire group. No obvious sternal complications developed in both groups. Our study showed a lower mean pain severity score in the ZipFix closure group compared with the conventional closure group at all study time points. Conclusion: The application of the ZipFix system for adult patients undergoing cardiac surgery through median sternotomy is safe and effective, which can significantly shorten the operation time of sternal closure and reduce postoperative pain.

並列關鍵字

Cardiac surgery ； Median sternotomy ； Sternal closure ； ZipFix system

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