Carter A R, Sostman H D, Curtis A M, Swett H A
AJR Am J Roentgenol. 1983 Mar;140(3):475-81. doi: 10.2214/ajr.140.3.475.
A series of 92 adult patients undergoing elective cardiac surgery was reviewed to distinguish routine postoperative radiographic alterations from signs of clinically significant complications. Two postoperative complications required decisive clinical intervention: mediastinal hemorrhage (7% of cases) and sternal wound infections (3% of cases). Mediastinal hemorrhage was most often diagnosed by excessive bloody mediastinal tube drainage alone, although progressive mediastinal widening and pleural or apical extrapleural hematomas provided corroborating or, rarely, the sole evidence of mediastinal hemorrhage. Sternal wound infections were most often diagnosed clinically, but increasing pre- and retrosternal gas collections provided radiographic confirmation. Atelectasis was the most common postoperative finding. There were many abnormal gas and soft-tissue collections posteroperatively that were notable for their lack of clinical importance. Serial postoperative films were necessary to demonstrate the progression of radiographic findings which indicate the two important postoperative complications.
对92例接受择期心脏手术的成年患者进行了回顾性研究，以区分术后常规影像学改变与具有临床意义的并发症体征。两种术后并发症需要果断的临床干预：纵隔出血（7%的病例）和胸骨伤口感染（3%的病例）。纵隔出血最常仅通过纵隔引流管引流出过多血性液体来诊断，尽管纵隔进行性增宽以及胸膜或胸膜外顶部血肿可提供佐证，或很少情况下作为纵隔出血的唯一证据。胸骨伤口感染最常通过临床诊断，但胸骨前和胸骨后气体积聚增加可提供影像学证实。肺不张是最常见的术后表现。术后有许多异常的气体和软组织积聚，其特点是缺乏临床重要性。术后连续拍片对于显示影像学表现的进展很有必要，这些表现提示了两种重要的术后并发症。
