骨蜡在非体外循环冠状动脉手术中有意义吗?一项前瞻性随机研究。

Zdenek Sorm, Martin Vobornik, Martin Dergel, Eva Cermakova, Jan Harrer, Jan Gofus
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摘要

前言:目前文献尚未报道骨蜡对非体外循环冠状动脉手术中胸骨感染和术中出血的影响。目的:对我院接受非体外循环冠状动脉手术的高危患者进行前瞻性评价。还研究了对细胞保存器利用的潜在影响。材料与方法:对58例采用非泵手术治疗双支冠状动脉病变的糖尿病患者进行前瞻性随机研究。他们被随机分配到蜡组和不蜡组。结果:有蜡组(550 ml)术中出血量与无蜡组(750 ml)术中出血量差异无统计学意义;P = 0.0711)。在多因素分析中,骨蜡的缺失(未使用)(优势比= 3.9 (1.12-13.51),p = 0.027)和术前创造素水平(优势比= 1.1 (0.99-1.03),p = 0.03)被确定为失血量≥750 ml的独立预测因素。两组住院期间红细胞单位数相似(p = 0.42)。两组均未见创面愈合并发症。结论:使用骨蜡不会增加胸骨伤口感染的风险。它可以减少术中大量失血的风险,从而避免在非体外循环冠状动脉手术中需要细胞保存器。然而,这种影响仍然值得怀疑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Does bone wax make sense in off-pump coronary surgery? A prospective randomized study.

Introduction: The effect of bone wax on sternal infection and intraoperative bleeding in off-pump coronary surgery has not been reported in current literature.

Aim: To prospectively evalute this in a cohort of high risk patients undergoing off-pump coronary artery surgery at our institution. The potential impact on cell saver utilization was also studied.

Material and methods: A prospective randomized study was performed in 58 diabetic patients operated on for two-vessel coronary artery disease by the off-pump technique. They were randomly assigned to the wax or no-wax group.

Results: There was no significant difference in intraoperative blood loss between the wax (550 ml) and no-wax group (750 ml; p = 0.0711). In multivariate analysis the absence (non-use) of bone wax (odds ratio = 3.9 (1.12-13.51), p = 0.027) and preoperative creatinin level (odds ratio = 1.1 (0.99-1.03), p = 0.03) were identified as independent predictors of blood loss ≥ 750 ml. The number of red blood cell units during hospital stay was similar in both groups (p = 0.42). Wound healing complications were not observed in either group.

Conclusions: The use of bone wax does not lead to a higher risk of sternal wound infection. It may reduce the risk of high intraoperative blood loss, thus avoiding the need of a cell saver during off-pump coronary surgery. However, this influence remains questionable.

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来源期刊
CiteScore
0.90
自引率
14.30%
发文量
44
审稿时长
6-12 weeks
期刊介绍: Polish Journal of Thoracic and Cardiovascular Surgery is a quarterly aimed at cardiologists, cardiosurgeons and thoracic surgeons. Includes the original works (experimental, research and development), illustrative and casuistical works about cardiology and cardiosurgery.
期刊最新文献
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