剑突下小切口非胸腔镜辅助Nuss手术矫治小儿漏斗胸  

Subxiphoid small incision assisting Nuss operation to cure pediatric pectus excavatum by non-thoracoscope method

作　　者：刘威[1] 梁建华[1] 唐志贤[1] 王勇[1] 

机构地区：[1]广州市儿童医院胸外科,510120

出　　处：《实用医学杂志》2009年第19期3255-3257,共3页The Journal of Practical Medicine

摘　　要：目的:探讨剑突下小切口非胸腔镜辅助Nuss手术矫治漏斗胸的改良手术方法和治疗经验。方法:61例小儿漏斗胸取剑突下纵行小切口,非胸腔镜辅助下完成Nuss手术治疗,其中男52例,女9例。年龄3岁6个月～14岁,中位年龄9岁6个月。结果:61例患儿均顺利完成手术,手术平均耗时50min,平均出血5mL。2例右侧胸膜术中破损,其中1例术后发生右胸腔积液及双侧伤口感染。平均术后住院时间5d。矫形效果59例为满意,2例为良好。结论:剑突下小切口非胸腔镜辅助Nuss手术,通过剑突下切口扩大前纵隔"范围",利用手指的感知及保护作用,能有效避免在使用专用器具时可能引发的心脏损伤;术中不使用胸腔镜,无额外胸膜破损,可极大地减少肺部并发症。手术安全可靠、方法简单且要领易于掌握,尤适合于不具备胸腔镜设备的医院开展小儿漏斗胸的矫治工作。Objective To establish a revised operation method of subxiphoid small incision assisting Nuss operation to cure pediatric pectus excavatum with non-thoracoscope. Methods 61 patients, consisting of 52 male and 9 female, were performed subxiphoid longitudinal small incision for Nuss operation treatment with non-thoracoscope assisting method The children were 3 years and 6 months to 14 years old, and median age is 9 years and 6 months. Results All 61 operations were carried out successfully, the average operation time was 50 min, and the average amount of bleeding was 5 mL. The right pleura was ruptured in 2 cases, among them, 1 case was suffered with right pleural effusion and bilateral wound infection. The average length of postoperative hospitalization was 5 days. The effect of orthopedic operation of 59 cases was satisfactory and 2 cases was good. Conclusions The subxiphoid small incision assisting Nuss operation with non-thoracoscope can enlarge anterior mediastinum scope by subxiphoid small incision. The cardiac impairment and lung complication could be efficiently avoided. This operation method is safe and easy to operate and grasp the main points, and especially suitable for those hospital not possessing thoracoscope equipments for orthopedic operations.

关 键 词：漏斗胸 改良手术 NUSS手术 

分 类 号：R726.5[医药卫生—儿科]