Eastridge C E, Mahfood S S, Walker W A, Cole F H
Division of Thoracic Surgery, Veterans Administration Medical Center, Memphis, Tennessee 38104.
Ann Thorac Surg. 1991 Jan;51(1):56-9. doi: 10.1016/0003-4975(91)90448-y.
This report describes 18 patients with disabling chest wall pain due to one or more sternal wire sutures. The pain occurred from 2 to 84 months after a median sternotomy. The pain was described either as sharp and stabbing or as a deep-seated ache. The involved wires had an exaggerated fibrous tissue reaction surrounding the twisted portion. The adjacent noninvolved wires had minimal reaction. In the last 7 patients, serial sections of the fibrous tissue revealed entrapment of one or more sensory nerve fibers. In 6 of the 7 electrical potentials were measured and found to be elevated, indicating wire damage during twisting. Ferroxyl tests confirmed the collection of iron ions at this anodic point as a result of corrosion. Removal of the involved wires and the fibrous tissue surrounding this anodic point relieved the symptoms of pain and tenderness resulting from entrapped sensory nerves.
本报告描述了18例因一根或多根胸骨钢丝缝线导致胸部顽固性疼痛的患者。疼痛发生在正中胸骨切开术后2至84个月。疼痛被描述为刺痛或深部隐痛。受累钢丝在扭曲部分周围有过度的纤维组织反应。相邻未受累的钢丝反应轻微。在最后7例患者中，纤维组织的连续切片显示一根或多根感觉神经纤维被卡压。在7例中的6例中测量了电位，发现电位升高，表明在扭曲过程中钢丝受损。亚铁氰化钾试验证实由于腐蚀在这个阳极点有铁离子聚集。去除受累钢丝及该阳极点周围的纤维组织可缓解因感觉神经受压导致的疼痛和压痛症状。
