Altern Ther Health Med. 2024 Jan;30(1):351-357.
The objective of this study was to assess the safety and patient satisfaction of sternal wire removal surgery, rendering reference for clinical practice in the future.
A total of 70 adolescent patients with completely healed sternum and no other diseases or able to receive surgery were randomly selected and subjected to sternal wire removal surgery. Besides, relevant data including patient age, gender, wire rupture, reason for wire removal, postoperative wire residuals, patient satisfaction, age at cardiac surgery, waiting time after cardiac surgery, and removal duration were recorded.
Raptured wire group exhibited higher proportions of males and chest pain cases and longer operative time than unruptured wire group. The demand for wire removal had no relation to gender, but patients receiving surgery due to chest pain were mainly aged 12-15 years old, those undergoing surgery due to employment and further education were mainly aged 9-12 years old, and those subjected to surgery sue to ruptures found in physical examinations were mainly aged 6-9 years old. According to statistics of wire rupture position, the rupture of the 4th wire accounted for the largest proportion, and rupture of multiple wires was found in some patients. No statistically significant differences were found in gender, age, age at cardiac surgery, and waiting time after cardiac surgery between patients with only one wire ruptured and those with multiple wires ruptured. Patients were grouped based on the absence and presence of chest pain, and it was found that chest pain group had a longer removal duration, but comparable age at cardiac surgery and waiting time after cardiac surgery, and the waiting time after cardiac surgery was a risk factor for chest pain. The waiting time after cardiac surgery was positively correlated with operative time, so we recommend that if there were symptoms of chest discomfort, it should be removed as soon as possible. However, due to the needs of the patients, no control group was set up, which is the limitation of this study. In the next step, we will conduct more long-term observation of the patients to confirm whether the chest pain can be relieved by itself without removing the wire.
This study found that for adolescent patients with chest pain or other life troubles after cardiac surgery, removing the sternal internal fixation wire can quickly and effectively relieve the troubles, and is a safe and reliable treatment means. Therefore, if it is necessary to remove the wire, it should be removed as soon as possible to avoid wire breakage and increase the difficulty of surgery.
本研究旨在评估胸骨钢丝拆除手术的安全性和患者满意度，为未来的临床实践提供参考。
选取 70 例胸骨完全愈合且无其他疾病或可接受手术的青少年患者，随机行胸骨钢丝拆除术，记录患者年龄、性别、钢丝断裂、钢丝拆除原因、术后钢丝残留、患者满意度、心脏手术年龄、心脏手术后等待时间和手术时间等相关数据。
钢丝断裂组男性和胸痛病例比例较高，手术时间较钢丝未断裂组长。钢丝拆除需求与性别无关，但因胸痛接受手术的患者主要为 12-15 岁，因就业和继续教育接受手术的患者主要为 9-12 岁，因体检发现钢丝断裂而接受手术的患者主要为 6-9 岁。根据钢丝断裂位置统计，第 4 根钢丝断裂比例最大，部分患者存在多根钢丝断裂。仅 1 根钢丝断裂和多根钢丝断裂患者的性别、年龄、心脏手术年龄和心脏手术后等待时间差异无统计学意义。根据是否存在胸痛将患者分为两组，发现胸痛组的拆除时间较长，但心脏手术年龄和心脏手术后等待时间无差异，心脏手术后等待时间是胸痛的危险因素。心脏手术后等待时间与手术时间呈正相关，因此建议如果出现胸痛等不适症状，应尽快拆除钢丝。但由于患者的需求，本研究未设置对照组，这是本研究的局限性。下一步我们将对患者进行更多的长期观察，以确认胸痛是否可以在不拆除钢丝的情况下自行缓解。
本研究发现，对于心脏手术后出现胸痛或其他生活困扰的青少年患者，拆除胸骨内固定钢丝可快速有效缓解困扰，是一种安全可靠的治疗手段。因此，如果有必要拆除钢丝，应尽快拆除，避免钢丝断裂，增加手术难度。
