Chronic Sternal Fistulae after Recurrent Cardiac Operations

反覆心臟手術後之慢性胸骨廔管

袁師敏(Shi-Min Shi) ； 欣菲爾德•阿米海(Amihay Shinfeld) ； 萊法埃麗•亞埃爾(Yael Refaely) ； 米沙利•大衛(David Mishaly)

《中華民國兒童胸腔醫學會雜誌》 5卷4期 (2008/08) Pp. 41-46

https://doi.org/10.6322/JPRD.200808_5(4).0006

摘要

胸骨虞廔管是心臟手術之後罕見的合併症。一位男性少年在反覆的胸骨正中切關手術之後發生胸骨傷口成染。由於併發扁桃腺炎，清創術被延誤。而代之以大劑量抗生素治療。電腦斷層和核磁共振攝影證實胸骨虞管的形成。胸骨廔管切除術中，發生無法控制的右心室壁的出血，逐緊急建立股動脈及股靜脈心肺旁路以支持切除術。然後，以胸大肌辮重建胸骨傷口。其傷口在手術之後癒合良好。證實切除術和胸大肌辮重建是治療胸骨廔管的良策。

關鍵字

心肺旁路 ； 胸大肌瓣 ； 胸骨廔管 ； 胸骨傷口感染 ； 胸骨正中切開手術 ； 扁桃腺炎

並列摘要

Sternal fistulae are a seldom event after cardiac surgery. A male teenager developed a sternal wound infection after recurrent sternotomies. Computerized tomographic scan and magnetic resonance imaging illustrated the formation of sternal fistulae. Owing to the tonsillitis， the débridement was delayed. Instead, a high dose of antibiotics was administered to the patient. When resection of sternal fistulaeae was performed， an uncontrollable right ventricular wall hemorrhage occurred, and urgent femorofemoral cardiopulmonary bypass had to be instituted to support the resection. Then, the sternal wound was reconstructed with pectoralis major muscle flaps. His wound was well-healed after operation. Resection and reconstruction with flaps proved a good method to treat sternal fistulae.

並列關鍵字

cardiopulmonary bypass ； pectoralis major muscle flaps ； sternal fistulae ； sternal wound infection ； sternotomy ； tonsillitis