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胸骨正中切开术后上肢症状和体症并非少见,一般认为同手臂位置不当和胸骨过度拉开损伤臂(神经)丛有关。 1965年以来,凡胸骨正中切开的病人均采用Jackson和Koats所述的“举臂仰卧位”,即:双臂外展90°,肩部抬高,肘弯曲并高于床面20cm。选择原无神经疾患、胸骨正中切开术后存活的335例患者为对象,绝大多数接受冠状动脉旁路移植术和/或心脏瓣膜替换术。麻醉后穿刺右侧颈内静脉供输血补液之用,仅23例穿刺失败者改为左侧颈内静脉穿刺。术后5～7天复查臂丛神经功能,凡有异常者每2天复查一次直至出院。检查结果28例(8.4％)患者术后出现新的症状
Sternal midline incision surgery symptoms and physical symptoms are not uncommon, generally believed that with the improper positioning of the arm and the excessive stretching of the sternum injury arm (nerve) plexus. Since 1965, all patients undergoing midsternal suturing have used the “supine arm lift” described by Jackson and Koats, with an armsout of 90 °, a raised shoulder, an elbow flexed 20 cm above the bed. A total of 335 patients who survived without a previous neurological condition and a median sternotomy were selected for the study, with the vast majority of patients undergoing coronary artery bypass grafting and / or heart valve replacement. After anesthesia puncture the right side of the internal jugular vein for transfusion rehydration, only 23 cases of puncture failure to the left jugular vein puncture. 5 to 7 days after the review of brachial plexus nerve function, where abnormalities were reviewed every 2 days until discharged. Examination results 28 patients (8.4%) patients with new symptoms after surgery