背景:导线和针脚在心脏内的迁移是一种罕见的并发症。克氏针的心内移可引起多种并发症。
方法:一名55岁男性患者因呼吸困难入院接受急诊服务,刺痛胸痛.患者的病史显示,他在大约5个月前接受了使用克氏针和钢板的固定手术,以治疗右胸锁关节脱位。胸部计算机断层扫描显示金属异物位于主动脉和右心室之间的心包中。由于及时发现潜在风险,术前未发生严重并发症。在没有体外循环的情况下,在全身麻醉下通过正中胸骨切开术进行金属丝去除。术后呼吸困难和胸痛症状缓解,病人康复了,没有任何并发症。
结论:克氏针应在骨科手术中的两栖动物中明智地使用,以免产生断裂和迁移的风险。当使用克氏针进行手术后出现胸部症状时,应考虑线心内迁移的可能性。必须立即移除迁移的电线以防止严重的并发症。建议定期随访和早期拔除固定丝,以防止丝迁移。
BACKGROUND: Migration of wires and pins within the heart is an uncommon complication. Intracardic migration of Kirschner wire can cause several complications.
METHODS: A 55-year-old male patient was admitted to the emergency service with dyspnea, stabbing chest pain. The patient\'s medical history showed that he had undergone a fixation operation using Kirschner wire and plate for treatment of the right sternoclavicular joint dislocation about 5 months prior. Chest computerized tomography revealed a metallic foreign body locating in the pericardium between the aorta and the right ventricle. There were not any serious complications occurred before operation due to the timely detection of potential risks. Removal of the wire was performed via median sternotomy under general anesthesia without cardiopulmonary bypass. The symptoms of dyspnea and chest pain were relieved after surgery, and the patient recovered without any complications.
CONCLUSIONS: The Kirschner wire should be used judiciously in amphiarthrosis in orthopedic surgery for the risk of breakage and migration. The possibility of intracardiac migration of wire should be considered when chest symptoms presenting after surgery with the Kirschner wire. Migrated wires must be removed immediately to prevent serious complications. Regular follow-up and early removal of fixation wires are recommended to prevent migration of wires.