[术后胸锁乳突炎:病变形态、治疗策略]。

Q4 Medicine Khirurgiya Pub Date : 2024-01-01 DOI:10.17116/hirurgia202407178
I A Vinokurov, Yu V Belov, D G Tagabilev, S A Yusupov
{"title":"[术后胸锁乳突炎:病变形态、治疗策略]。","authors":"I A Vinokurov, Yu V Belov, D G Tagabilev, S A Yusupov","doi":"10.17116/hirurgia202407178","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To analyze bone tissue damage at different stages of disease (El Oakley classification), treatment options for each clinical situation and results after each approach.</p><p><strong>Material and methods: </strong>There were 45 patients with wound complications after cardiac surgery between October 2022 and September 2023. Thirty-eight (84.4%) patients underwent CABG, 7 (15.6%) patients - heart valve or aortic surgery. Mean age of patients was 68.1±10.3 years. There were 35 men (77.8%) and 10 women (22.2%). The first type was found in 11 (24.5%) patients, type 2-3 - 19 (42.2%), type 4 - 4 (8.8%), type 5 - 11 (24.5%) patients.</p><p><strong>Results: </strong>Systemic inflammatory response syndrome was observed in 7 (36.8%) persons of the 1<sup>st</sup> group, 14 (73.7%) ones of the 2<sup>nd</sup> group, 4 (100%) patients of the 3<sup>rd</sup> group and 2 (18.2%) patients of the 4<sup>th</sup> group. C-reactive protein and procalcitonin increased in all patients with the highest values in groups 2 and 3. Redo soft tissue inflammation occurred in all groups after treatment. Mean incidence was 25%. Two (10.5%) patients died in the 2<sup>nd</sup> group and 1 (25%) patient in the 3<sup>rd</sup> group.</p><p><strong>Conclusion: </strong>The modern classification of sternomediastinitis does not fully characterize severity of disease in a particular patient. Simultaneous debridement with wound closure demonstrates acceptable mortality (within 10%). The highest mortality rate was observed in patients with diffuse lesions of the sternum. Less aggressive treatment approaches are possible for stable anterior chest wall.</p>","PeriodicalId":35986,"journal":{"name":"Khirurgiya","volume":" 7","pages":"78-84"},"PeriodicalIF":0.0000,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Postoperative sternomediastinitis: morphology of lesion, treatment strategy].\",\"authors\":\"I A Vinokurov, Yu V Belov, D G Tagabilev, S A Yusupov\",\"doi\":\"10.17116/hirurgia202407178\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>To analyze bone tissue damage at different stages of disease (El Oakley classification), treatment options for each clinical situation and results after each approach.</p><p><strong>Material and methods: </strong>There were 45 patients with wound complications after cardiac surgery between October 2022 and September 2023. Thirty-eight (84.4%) patients underwent CABG, 7 (15.6%) patients - heart valve or aortic surgery. Mean age of patients was 68.1±10.3 years. There were 35 men (77.8%) and 10 women (22.2%). The first type was found in 11 (24.5%) patients, type 2-3 - 19 (42.2%), type 4 - 4 (8.8%), type 5 - 11 (24.5%) patients.</p><p><strong>Results: </strong>Systemic inflammatory response syndrome was observed in 7 (36.8%) persons of the 1<sup>st</sup> group, 14 (73.7%) ones of the 2<sup>nd</sup> group, 4 (100%) patients of the 3<sup>rd</sup> group and 2 (18.2%) patients of the 4<sup>th</sup> group. C-reactive protein and procalcitonin increased in all patients with the highest values in groups 2 and 3. Redo soft tissue inflammation occurred in all groups after treatment. Mean incidence was 25%. Two (10.5%) patients died in the 2<sup>nd</sup> group and 1 (25%) patient in the 3<sup>rd</sup> group.</p><p><strong>Conclusion: </strong>The modern classification of sternomediastinitis does not fully characterize severity of disease in a particular patient. Simultaneous debridement with wound closure demonstrates acceptable mortality (within 10%). The highest mortality rate was observed in patients with diffuse lesions of the sternum. Less aggressive treatment approaches are possible for stable anterior chest wall.</p>\",\"PeriodicalId\":35986,\"journal\":{\"name\":\"Khirurgiya\",\"volume\":\" 7\",\"pages\":\"78-84\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-01-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Khirurgiya\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.17116/hirurgia202407178\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Khirurgiya","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.17116/hirurgia202407178","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0

摘要

摘要分析不同疾病阶段的骨组织损伤(埃尔-奥克利分类)、每种临床情况下的治疗方案以及每种方法后的效果:2022年10月至2023年9月期间,45名患者在心脏手术后出现伤口并发症。其中 38 例(84.4%)患者接受了 CABG 手术,7 例(15.6%)患者接受了心脏瓣膜或主动脉手术。患者平均年龄为(68.1±10.3)岁。其中男性 35 人(77.8%),女性 10 人(22.2%)。11例(24.5%)患者为第一型,19例(42.2%)为第二至第三型,4例(8.8%)为第四型,11例(24.5%)为第五型:结果:第一组有 7 人(36.8%)、第二组有 14 人(73.7%)、第三组有 4 人(100%)、第四组有 2 人(18.2%)出现了全身炎症反应综合征。所有患者的 C 反应蛋白和降钙素原都有所增加,其中第 2 组和第 3 组的数值最高。所有组别在治疗后都出现了软组织炎症。平均发生率为 25%。第 2 组有 2 名(10.5%)患者死亡,第 3 组有 1 名(25%)患者死亡:结论:胸锁乳突炎的现代分类并不能完全描述特定患者的病情严重程度。同时进行清创和伤口闭合可降低死亡率(10%以内)。胸骨弥漫性病变患者的死亡率最高。对于病情稳定的前胸壁患者,可以采取不那么激进的治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
[Postoperative sternomediastinitis: morphology of lesion, treatment strategy].

Objective: To analyze bone tissue damage at different stages of disease (El Oakley classification), treatment options for each clinical situation and results after each approach.

Material and methods: There were 45 patients with wound complications after cardiac surgery between October 2022 and September 2023. Thirty-eight (84.4%) patients underwent CABG, 7 (15.6%) patients - heart valve or aortic surgery. Mean age of patients was 68.1±10.3 years. There were 35 men (77.8%) and 10 women (22.2%). The first type was found in 11 (24.5%) patients, type 2-3 - 19 (42.2%), type 4 - 4 (8.8%), type 5 - 11 (24.5%) patients.

Results: Systemic inflammatory response syndrome was observed in 7 (36.8%) persons of the 1st group, 14 (73.7%) ones of the 2nd group, 4 (100%) patients of the 3rd group and 2 (18.2%) patients of the 4th group. C-reactive protein and procalcitonin increased in all patients with the highest values in groups 2 and 3. Redo soft tissue inflammation occurred in all groups after treatment. Mean incidence was 25%. Two (10.5%) patients died in the 2nd group and 1 (25%) patient in the 3rd group.

Conclusion: The modern classification of sternomediastinitis does not fully characterize severity of disease in a particular patient. Simultaneous debridement with wound closure demonstrates acceptable mortality (within 10%). The highest mortality rate was observed in patients with diffuse lesions of the sternum. Less aggressive treatment approaches are possible for stable anterior chest wall.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
Khirurgiya
Khirurgiya Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
161
期刊介绍: Хирургия отдельных областей сердце, сосуды легкие пищевод молочная железа желудок и двенадцатиперстная кишка кишечник желчевыводящие пути печень
期刊最新文献
[Endoscopic stenting for malignant pancreatobiliary strictures]. [Ankle replacement for severe post-traumatic deformation of the distal tibia: a case report]. [Comparative analysis of in-hospital and long-term results of patients with acute dysfunction of coronary bypass grafts depending on treatment tactics]. [Efficacy and safety of surgical treatment of patients with pathological tortuosity of the internal carotid artery]. [Endoscopic vacuum therapy in minimally invasive treatment of esophageal perforations].
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1