Inoue M, Sano S, Kino K, Kawada M, Irie H, Sugawara E, Aoki A
Department of Cardiovascular Surgery, Okayama University Medical School, Japan.
Kyobu Geka. 2000 Aug;53(9):729-33.
Between November 1992 and February 1996, 84 patients (less than 3 months of age) underwent open heart surgery. Among 76 patients except 8 who required mechanical circulatory support, the sternum was left open. The indication of open sternotomy was hypoplastic left heart syndrome in 14 patients and unstable hemodynamics in 4 patients. Three patients died before delayed sternal closure. Delayed sternal closure was carried out in 15 patients with a mean of 4.7 days postoperatively. By the time of sternal closure, blood pressure, left atrial pressure and respiratory parameters improved and inotropics were reduced with the minus fluid balance. One patient died of sepsis 4 days after delayed sternal closure. Delayed sternal closure was effective modality to neonates or early infants after complex open heart surgery.
1992年11月至1996年2月期间,84例(年龄小于3个月)患者接受了心脏直视手术。在76例除8例需要机械循环支持外的患者中,胸骨保持开放。胸骨切开术的指征为14例左心发育不全综合征和4例血流动力学不稳定。3例患者在延迟胸骨闭合前死亡。15例患者进行了延迟胸骨闭合,平均在术后4.7天。到胸骨闭合时,血压、左心房压力和呼吸参数改善,且随着液体负平衡,血管活性药物用量减少。1例患者在延迟胸骨闭合后4天死于败血症。延迟胸骨闭合对复杂心脏直视手术后的新生儿或早期婴儿是一种有效的方式。