Muehrcke Derek D, Shimp Will M, Aponte-Lopez Rafael
Department of Cardiac Surgery, Flagler Hospital, St. Augustine, Florida, USA.
Ann Thorac Surg. 2009 Nov;88(5):1658-61. doi: 10.1016/j.athoracsur.2009.05.058.
Calcium phosphate cements control bleeding and are safe to use in osteoporotic sternums during open heart surgery. We looked at the clinical and radiographic effects of this agent on bone healing.
Since March 2006, 18 patients had calcium phosphate cement inserted in their sternal tables at heart surgery. They were followed-up by office visits and chest computed tomographic (CT) scans. All preoperative and postoperative CT chest scans were evaluated for cement absorption, bone replacement, and bone density.
Five preoperative and 41 postoperative CT chest scans were available for evaluation. Median interval from surgery to CT scan was 531 days (range, 3 to 966 days). At follow-up there were neither clinical dehiscences nor nonunions of the sternums. Calcium phosphate cement appears to reabsorb quickly, but not completely. Five patients with pre-surgical CT chest scans demonstrated an average, improved bone density of 281.66 Hounsfield units at follow-up (p = 0.006).
In each patient, cement was replaced by new bone, and there is evidence that more bone is present as a result of cement use.
磷酸钙骨水泥可控制出血，且在心脏直视手术中用于骨质疏松的胸骨时使用安全。我们研究了该制剂对骨愈合的临床和影像学影响。
自2006年3月起，18例患者在心脏手术时于胸骨板植入磷酸钙骨水泥。通过门诊随访和胸部计算机断层扫描（CT）进行跟踪。对所有术前和术后胸部CT扫描评估骨水泥吸收、骨替代和骨密度情况。
有5次术前和41次术后胸部CT扫描可供评估。从手术到CT扫描的中位间隔时间为531天（范围3至966天）。随访时既无胸骨临床裂开也无骨不连情况。磷酸钙骨水泥似乎吸收迅速，但不完全。5例术前行胸部CT扫描的患者随访时平均骨密度提高281.66亨氏单位（p = 0.006）。
在每位患者中，骨水泥被新骨替代，且有证据表明使用骨水泥后有更多骨组织生成。
