双支架Nuss手术治疗青少年漏斗胸  

Nuss procedure for the correction of pectus excavatum by using double braces in adolescence

作　　者：刘全[1] 王建军[1] 赵峰[1] 翟伟[1] 严会智[1] 

机构地区：[1]华中科技大学附属协和医院胸外科,武汉430022

出　　处：《中华胸心血管外科杂志》2011年第5期291-292,共2页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的探讨使用双支架治疗青少年大范围漏斗胸微创Nuss手术的适应证、可行性和手术方法及效果。方法31例中男24例，女7例；年龄14～18岁，平均（15．32±3．12）岁。根据Hallar指数均评价为中到重度，凹陷范围为4个肋间以上。选择胸腔镜辅助Nuss手术两点或者多点双支架支撑固定法手术。结果均采用双支架在胸腔镜辅助下顺利完成Nuss手术。术后住院5～10天，平均（7．48±1．95）天；随访4个月到5年。术中发生出血2例，支架滑动移位和间断疼痛2个月各1例，均治愈。结论胸腔镜辅助双支架矫正大面积、不对称漏斗胸的Nuss手术对青少年是一种安全、有效的方法。Objective To investigate the indication, feasibility and technique of minimally invasive nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence. Methods 31 patients including 24 boys and 7 girls, suftered from pectus excavtum were corrected by nuss procedure under thoracoseope. The average age was （ 15.32 ± 3.89）years （ ranged, 14 years and 18 years）. All cases were ruoderale to severe degree according to Hallar index with depression scope of 4 ribs or more. A couple of braces of two-point or multipoint fixation for thoracoscopie-assisted nuss procedure were used. Results The procedure was successfully completed under thoracoseopy in all patients. Double braces were utilized in 27 cases, double arc bars were required in 4 cases, and muhipoint fixations were in 6 patients. The postoperative hospital stay was 5 - 11 days [ average, （7.48 ±1.95） daysl. The duration of following up was one month to three years. The perioperative complications included intraoperative hemorrhage in 2 patients, bar invertion with displacement in 1, and interrupted pain for two months in 1. All patients recovered after expectant treatment. Conclusion Nuss procedure with double braces for the correction of a large area of asymmetric pectus excavatum under thoracoscopy is safe rant effective technique for adolescence.

关 键 词：漏斗胸 支架 青少年 NUSS手术 

分 类 号：R655[医药卫生—外科学]