Ronday M, Damen J, van der Tweel I
Department of Cardiac Anesthesiology, University Hospital, Utrecht, The Netherlands.
J Cardiothorac Vasc Anesth. 1993 Oct;7(5):535-7. doi: 10.1016/1053-0770(93)90309-9.
In previous studies pleurotomy has seldom been reported as a complication of sternotomy and, therefore, the incidence is unknown. Factors increasing or decreasing the risk of pleurotomy also have not been studied properly. In a prospective, randomized trial, performed during 14 consecutive months from 1988 until 1989, the incidence of pleurotomy and its possible risk factors were studied in 712 patients undergoing median sternotomy for cardiac and mediastinal procedures. The overall incidence of pleurotomy was 14.7%. Chronic obstructive pulmonary disease, the use of positive end-expiratory pressure, and continuation or discontinuation of the ventilatory system did not affect the incidence. A surgeon-related risk factor could be significantly identified (P < 0.001). In conclusion, disconnection of the ventilatory system during sternotomy has been shown to have no influence on the pleurotomy rate and its continued use is no longer valid.
在以往的研究中，很少有关于胸膜切开术作为胸骨切开术并发症的报道，因此其发生率尚不清楚。增加或降低胸膜切开术风险的因素也未得到充分研究。在1988年至1989年连续14个月期间进行的一项前瞻性随机试验中，对712例接受心脏和纵隔手术正中胸骨切开术的患者的胸膜切开术发生率及其可能的危险因素进行了研究。胸膜切开术的总体发生率为14.7%。慢性阻塞性肺疾病、呼气末正压的使用以及通气系统的持续或中断均不影响发生率。可以显著确定一个与外科医生相关的危险因素（P<0.001）。总之，胸骨切开术期间通气系统的断开已被证明对胸膜切开术发生率没有影响，继续使用不再合理。
