心脏手术后臂丛损伤的发生率:一项回顾性研究

IF 0.1 Q4 ANESTHESIOLOGY Acta anaesthesiologica Belgica Pub Date : 2023-09-20 DOI:10.56126/74.3.16
J Heirbaut, H Gutermann, T Fret
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引用次数: 0

摘要

背景:臂丛病是一种罕见但衰弱性的心脏手术损伤。报道的发病率差异很大。几个危险因素已被描述,包括患者和手术因素。目的:本研究的目的是(1)调查三年来我院心脏手术中臂丛神经损伤的发生率,(2)概述臂丛神经病变的危险因素和可能的机制,(3)考虑这些损伤的法律后果。设计与背景:单中心回顾性研究方法:回顾性收集某大医院三年内所有接受心脏手术患者的资料(N = 1305)。对手术后进行肌电图检查的患者进行医院记录筛选。进一步探讨臂丛神经损伤。获得患者特征和适用于术中神经损伤已知危险因素的数据。结果:1305例患者中臂丛神经损伤7例(0.54%)。所有臂丛神经损伤患者均行冠状动脉搭桥手术,并在损伤侧切除乳腺内动脉。由于只发现了7例,并怀疑漏报,因此没有对危险因素进行进一步分析。结论:我们的数据表明心脏手术中的臂丛损伤可能与乳腺内动脉切除时胸骨不对称回缩有关。这些发现与先前的报道一致,尽管进一步调查确切位置和使用牵开器类型的重要性将是有趣的。
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Incidence of brachial plexus injury after cardiac surgery: a retrospective study
Background: Brachial plexopathy is a rare but debilitating injury associated with cardiac surgery. The reported incidence varies widely. Several risk factors have been described, including both patient and surgical factors. Objectives: The aim of this study is to (1) investigate the incidence of brachial plexus injury in cardiac surgery in a three-year period in our hospital, (2) give an overview of risk factors and possible mechanisms of brachial plexopathy, and (3) consider the legal ramifications of these injuries. Design and setting: single centre retrospective study Methods: Data were collected retrospectively from all patients undergoing cardiac surgery in a major hospital in a three-year year period (N = 1305). Hospital records were screened for patients who underwent an electromyography after their surgery. Those cases were further investigated for brachial plexus injury. Patient characteristics and data applying to known risk factors for peroperative nerve injury were obtained. Results: Brachial plexus injury was observed in 7 out of 1305 patients (0.54%). All patients with brachial plexus injury underwent coronary artery bypass surgery with internal mammary artery harvesting at the side of the injury. No further analysis concerning risk factors was performed since only seven cases were identified and underreporting was suspected. Conclusion: Our data suggest that brachial plexus injury in cardiac surgery might be associated with asymmetrical sternal retraction during internal mammary artery harvesting. These findings correspond with previous reports, although it would be interesting to further investigate the importance of the exact placement and type of retractor used.
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CiteScore
0.20
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0.00%
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期刊介绍: L’Acta Anaesthesiologica Belgica est le journal de la SBAR, publié 4 fois par an. L’Acta a été publié pour la première fois en 1950. Depuis 1973 l’Acta est publié dans la langue Anglaise, ce qui a été résulté à un rayonnement plus internationaux. Depuis lors l’Acta est devenu un journal à ne pas manquer dans le domaine d’Anesthésie Belge, offrant e.a. les textes du congrès annuel, les Research Meetings, … Vous en trouvez aussi les dates des Research Meetings, du congrès annuel et des autres réunions.
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