婴儿先天性心脏手术胸骨正中切口后胸部畸形的影响因素分析

IF 1.3 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiac Surgery Pub Date : 2023-02-08 DOI:10.1155/2023/8450105

Jian-Feng Liu, Wen-Hao Lin, Yu-Kun Chen, Qin Chen, Hua Cao

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Sternal pins for auxiliary sternal fixation were used in eighty-nine infants. After analysis, it was found that age at operation (1.9 ± 0.9 vs. 3.7 ± 1.2, \n \n P\n <\n 0.001\n \n ) and weight-for-age Z-scores (−2.0 ± 0.7 vs. −1.4 ± 0.7, \n \n P\n =\n 0.001\n \n ) of the thoracic deformity group were significantly lower than those of the no thoracic deformity group. In addition, sternal pin use was significantly higher in the no thoracic deformity group than in the thoracic deformity group (61.9% vs. 17.6%, \n \n P\n =\n 0.001\n \n ). Univariable analysis showed that age at operation (OR, 4.74; 95% CI, 2.38–9.46; \n \n P\n <\n 0.001\n \n ) and weight-for-age Z-scores (OR, 4.40; 95% CI, 1.74–11.12; \n \n P\n =\n 0.002\n \n ) were significant risk factors for postoperative thoracic deformity. Using sternal pins for auxiliary sternal fixation was an important protective factor (OR, 7.57; 95% CI, 2.08–27.59; \n \n P\n =\n 0.003\n \n ). Conclusions. 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引用次数: 0

摘要

客观的研究接受先天性心脏手术的婴儿胸骨正中切开术后胸部畸形的发生率，并确定其影响因素。方法。这是一项单中心回顾性研究。纳入2020年9月至2022年1月在中国一家省级医院接受胸骨正中切开术的156名婴儿。根据是否发生胸部畸形，将患者分为胸部畸形组和无胸部畸形组。通过电子病历系统检索相关数据，并进行统计比较和分析。后果该队列中术后胸部畸形的发生率为10.9%。89名婴儿使用胸骨钉辅助胸骨固定。经过分析，发现手术时的年龄（1.9 ± 0.9对3.7 ± 1.2，P＜0.001）和体重年龄Z评分（−2.0 ± 0.7对-1.4 ± 0.7，P=0.001）显著低于无胸畸形组。此外，无胸廓畸形组的胸骨钉使用率显著高于胸廓畸形对照组（61.9%对17.6%，P=0.001）。单变量分析显示，手术时的年龄（OR，4.74；95%CI，2.38-9.46；P<0.001）和体重与年龄的Z评分（OR，4.40；95%CI，1.74-111.12；P=0.002）是术后胸部畸形的重要危险因素。使用胸骨钉辅助胸骨固定是一个重要的保护因素（OR，7.57；95%CI，2.08–27.59；P=0.003）。结论。在这项研究中，10.9%通过正中胸骨切开术接受先天性心脏手术的婴儿在手术后出现胸部畸形。手术年龄较小和营养不良可能是术后胸部畸形的危险因素。胸骨钉辅助固定对预防胸廓畸形有积极作用。

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Analysis of Factors Influencing Thoracic Deformities after Median Sternotomy in Infants Who Underwent Congenital Cardiac Surgery

Objective. To investigate the incidence of thoracic deformities after median sternotomy in infants who underwent congenital cardiac surgery and determine its influencing factors. Methods. This was a single-center retrospective study. A total of 156 infants who underwent congenital cardiac surgery with median sternotomy in a provincial hospital in China from September 2020 to January 2022 were included. Depending on whether thoracic deformities occurred, the patients were classified into the thoracic deformity group and the no thoracic deformity group. Relevant data were retrieved through an electronic medical record system, and statistical comparisons and analyses were performed. Results. The incidence of postoperative thoracic deformities in this cohort was 10.9%. Sternal pins for auxiliary sternal fixation were used in eighty-nine infants. After analysis, it was found that age at operation (1.9 ± 0.9 vs. 3.7 ± 1.2, P < 0.001 ) and weight-for-age Z-scores (−2.0 ± 0.7 vs. −1.4 ± 0.7, P = 0.001 ) of the thoracic deformity group were significantly lower than those of the no thoracic deformity group. In addition, sternal pin use was significantly higher in the no thoracic deformity group than in the thoracic deformity group (61.9% vs. 17.6%, P = 0.001 ). Univariable analysis showed that age at operation (OR, 4.74; 95% CI, 2.38–9.46; P < 0.001 ) and weight-for-age Z-scores (OR, 4.40; 95% CI, 1.74–11.12; P = 0.002 ) were significant risk factors for postoperative thoracic deformity. Using sternal pins for auxiliary sternal fixation was an important protective factor (OR, 7.57; 95% CI, 2.08–27.59; P = 0.003 ). Conclusions. In this study, 10.9% of infants undergoing congenital cardiac surgery through a median sternotomy developed thoracic deformities after surgery. Younger age at operation and poor nutritional conditions may be risk factors for postoperative thoracic deformity. Sternal pin-assisted fixation has a positive effect on the prevention of thoracic deformities.

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来源期刊

Journal of Cardiac Surgery 医学-外科

CiteScore

2.90

自引率

12.50%

发文量

976

审稿时长

3-8 weeks

期刊介绍： Journal of Cardiac Surgery (JCS) is a peer-reviewed journal devoted to contemporary surgical treatment of cardiac disease. Renown for its detailed "how to" methods, JCS''s well-illustrated, concise technical articles, critical reviews and commentaries are highly valued by dedicated readers worldwide. With Editor-in-Chief Harold Lazar, MD and an internationally prominent editorial board, JCS continues its 20-year history as an important professional resource. Editorial coverage includes biologic support, mechanical cardiac assist and/or replacement and surgical techniques, and features current material on topics such as OPCAB surgery, stented and stentless valves, endovascular stent placement, atrial fibrillation, transplantation, percutaneous valve repair/replacement, left ventricular restoration surgery, immunobiology, and bridges to transplant and recovery. In addition, special sections (Images in Cardiac Surgery, Cardiac Regeneration) and historical reviews stimulate reader interest. The journal also routinely publishes proceedings of important international symposia in a timely manner.