Rikitake K, Sato M, Ohtsubo S, Itoh T
Department of Thoracic and Cardiovascular Surgery, Saga University, Saga, Japan.
Kyobu Geka. 2009 Mar;62(3):211-3.
We report a 73-year-old man with myelodysplastic syndrome (MDS) who developed Sweet's disease after off-pump coronary artery bypass grafting (OPCAB). Coronary angiography showed severe 3 vessel disease. We conducted OPCAB on triple vessels using bilateral internal thoracic artery and saphenous vein grafts. He had a high fever and rubor around the median skin incision on 5 postoperative day. Skin biopsy demonstrated acute febrile neutrophilic dermatitis (Sweet's disease). The cutaneous lesions improved gradually by corticosteroids. A careful attention should be paid postoperatively in a patient with hematological disorders such as MDS, aplastic anemia, and malignancy.
我们报告了一名73岁患有骨髓增生异常综合征（MDS）的男性患者，他在非体外循环冠状动脉搭桥术（OPCAB）后发生了Sweet病。冠状动脉造影显示严重的三支血管病变。我们使用双侧胸廓内动脉和大隐静脉移植物对三支血管进行了OPCAB。术后第5天，他在正中皮肤切口周围出现高热和红斑。皮肤活检显示急性发热性嗜中性皮病（Sweet病）。通过使用皮质类固醇，皮肤病变逐渐改善。对于患有血液系统疾病（如MDS、再生障碍性贫血和恶性肿瘤）的患者，术后应予以密切关注。
