Najczęstsze powikłania po sternotomii
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Najczęstsze powikłania po sternotomii

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Sternotomia to operacja polegająca na chirurgicznym przecięciu mostka na całej jego długości. Dzięki temu zabiegowi możliwe jest utworzenie dostępu do narządów klatki piersiowej podczas operacji. Jednak jak każda operacja niesie za sobą ryzyko wystąpienia powikłań, takich jak m.in. zakażenie i rozejście się szwu mostka.

U pacjentów po sternotomii oprócz zakażenia i rozejścia się szwu mostka, które najczęściej dotyka palaczy i chorych na przewlekłą obturacyjną chorobę płuc, odnotowuje się również niestabilność mostka i uszkodzenie splotu ramiennego. Symptomem tych powikłań jest ból, a niekiedy również częściowe porażenie jednej z kończyn górnych.

U pacjentów, u których doszło do zakażenia i rozejścia się szwu mostka, konieczne jest drenowanie zakażonej treści, antybiotykoterapia, a w niektórych przypadkach również ponowna operacja.

Kiedy wykonuje się sternotomię?

Operację przecięcia mostka przeprowadza się zazwyczaj podczas operacji kardiochirurgicznych, takich jak wymiana zastawek, wszycie by-passów (pomostowanie aortalno-wieńcowe) czy zabiegi na dużych naczyniach klatki piersiowej.

Sternotomia niekiedy jest również częścią operacji terakochirurgicznych, do których zalicza się usunięcia całego bądź części płuca, nowotworu płuca wraz z węzłami chłonnymi lub zabiegu na przełyku. Bardzo rzadko, ale zdarza się, iż operacja ta jest niezbędna podczas operacji tarczycy lub grasicy.

Operacja przecięcia mostka odbywa się w znieczuleniu ogólnym

W związku z tym, iż sternotomia jest bardzo poważnym zabiegiem operacyjnym, pacjenci wymagają po nim długiej rekonwalescencji i rehabilitacji.

Podczas sternotomii przecinana jest linia pośrodkowa na całej długości mostka, tkanka podskórna i okostna. Po zabiegu mostek wymaga rekonstrukcji. Oznacza to, iż zakładane są metalowe (niekiedy też plastikowe) szwy. Pozostają one w ciele pacjenta na zawsze. Ich zadaniem jest ustabilizowanie mostka do momentu zrośnięcia. Czas ten może wynosić nawet kilka miesięcy.

Niezwykle ważne jest również noszenie po zabiegu specjalnej kamizelki stabilizującej mostek. Ponadto pacjenci po sternotomii powinni unikać wysiłku oraz napinania klatki piersiowej.

Źródło: poradnikzdrowie.pl

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