Boiselle P M, Mansilla A V, White C S, Fisher M S
Department of Radiology at Beth Israel Deaconess Medical Center, Boston, MA 02215, USA.
J Thorac Imaging. 2001 Apr;16(2):106-10. doi: 10.1097/00005382-200104000-00008.
The authors compared patients with sternal dehiscence (SD) with and without mediastinitis with respect to: 1) time interval from surgery to diagnosis; and 2) frequency of sternal wire abnormalities on chest radiographs (CXR). Using a hospital information system to identify all patients with a diagnosis of SD from January 1993 through April 1999, the authors obtained clinical data by performing a retrospective chart review. For each patient, a CXR from the date of diagnosis of SD was retrospectively compared with the first postoperative CXR to assess for sternal wire displacement, rotation, and disruption. The timing of sternal wire alterations was correlated with clinical findings of SD or mediastinitis. The authors found that sternal wire abnormalities are evident radiographically in the majority of SD patients with and without mediastinitis; there is no significant difference in the frequency of sternal wire abnormalities between these two subgroups. Patients with SD and mediastinitis generally present later in the postoperative period than patients with isolated dehiscence.
作者比较了有和没有纵隔炎的胸骨裂开（SD）患者在以下方面的情况：1）从手术到诊断的时间间隔；2）胸部X线片（CXR）上胸骨钢丝异常的频率。作者利用医院信息系统识别出1993年1月至1999年4月期间所有诊断为SD的患者，通过回顾性病历审查获取临床数据。对于每位患者，将SD诊断日期的CXR与术后第一张CXR进行回顾性比较，以评估胸骨钢丝的移位、旋转和断裂情况。胸骨钢丝改变的时间与SD或纵隔炎的临床发现相关。作者发现，在大多数有和没有纵隔炎的SD患者中，胸骨钢丝异常在影像学上很明显；这两个亚组之间胸骨钢丝异常的频率没有显著差异。与单纯裂开的患者相比，患有SD和纵隔炎的患者通常在术后较晚出现症状。
