目的：分析在心脏手术中，骨蜡用于胸骨正中切口胸骨断面填塞止血的必要性。方法：连续入选2011-01至2014-12期间共445例患者，其中210例患者的胸骨断面使用骨蜡（骨蜡组），235例患者的胸骨断面未使用骨蜡（无骨蜡组）。分别比较两组患者的二次开胸止血情况以及12小时、24小时及总的引流量，关胸时间和输血率。结果：骨蜡组和无骨蜡组分别有2例和1例患者二次开胸止血，但与骨髓腔出血无关。两组患者的12小时、24小时及总引流量分别为（451±240）ml和（483±238）ml、（615±304）ml 和（639±285）ml、（842±467）ml和（842±364） ml（P均>0.05）。骨蜡组和无骨蜡组关胸时间分别为（68.0±23.0）min和（66.0±19.0）min（P>0.05）。骨蜡组和无骨蜡组总输血率分别是21%和19%（P>0.05）。结论：胸骨断面骨蜡的使用不会显著减少关胸后的引流量，也不会影响关胸速度。应舍弃骨蜡在胸骨断面止血中的应用。%Objective: To explore the necessity for application of bone wax stanching bleeding at sternal edge in cardiac surgery by median sternotomy. Methods: A total of 445 patients who receive cardiac surgery by the same surgeon performing median sternotomy in our hospital from 2011-01 to 2014-12 were studied. According to application of bone wax stanching bleeding, the patients were divided into 2 groups: Bone wax group,n=210 and Non-bone wax group,n=235. Re-thoracotomy for hemostasis, 12 h, 24 h and total draining volume after the operation and time of closing incision were compared between 2 groups. Results: There were 2 patients and 1 patient received re-thoracotomy for hemostasis in Bone wax group and Non-bone wax group respectively, which was not related to bone marrow cavity bleeding. In Bone wax group and Non-bone wax group, the draining volume at 12 h post-operation were (451 ± 240) ml vs (483 ± 238) ml, at 24 h post-operation were (615 ± 304) ml vs (639 ± 285) ml and the total volume were (842 ± 467) ml vs (842 ± 364) ml, allP>0.05; the time of closing incision were (68.0 ± 23.0 ) min vs (66.0 ± 19.0 ) min,P>0.05; the total transfusion rates were 21% vs 19%,P>0.05. Conclusion: Application of bone wax at sternum edge could neither affecting the drainage nor the speed of closing incision in cardiac surgery and therefore, it might be given up.
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