漏斗胸并其他心胸疾病的一期手术治疗  

Simultaneous Surgery of Pectus Excavatum with Other Cardiothoracic Diseases

作　　者：龚立[1] 皮名安[1] 童峰[1] 汪力[1] 王涛[1] 

机构地区：[1]武汉市儿童医院心胸外科,武汉430016

出　　处：《实用儿科临床杂志》2012年第5期380-382,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的总结漏斗胸并其他心胸疾病的一期手术治疗的经验。方法回顾性分析13例漏斗胸并其他心胸疾病同时行一期手术的患儿的资料,其中7例并先天性心脏病(先心)(4例并VSD,3例并ASD),4例并先天性肺囊肿,1例并膈膨升,1例并纵隔神经纤维瘤病。将患儿分为漏斗胸并先心组和漏斗胸并胸科疾病组,均采用Nuss手术纠治漏斗胸,并同期手术治疗相关疾病。同期随机选取30例单纯性先心患儿及10例单纯漏斗胸患儿作为对照组。并对手术前后的Hallar指数、手术时间、术后胸引量、术后胸管放置时间、术后机械通气时间和ICU时间等相关数据进行统计学分析。结果 13例患者均治愈出院,无严重并发症,术后Haller指数明显改善(P<0.05)。漏斗胸并先心组手术时间与单纯先心组及单纯漏斗胸组比较,其分布均有统计学差异(Pa<0.05)。漏斗胸并先心组和单纯先心组术后胸引量、术后胸管放置时间、术后机械通气时间、术后ICU时间比较差异均无统计学意义。术后心肺功能稳定,胸廓外形满意。结论一期手术治疗漏斗胸并胸部其他疾病是一种安全可行的治疗方案,避免或减少了分期手术,减轻了患者痛苦。Objective To summarize the experience of one-stage surgeries for pectus excavatum with other cardiothoracic diseases. Methods The clinical data of 13 cases of pectus excavatum with cardiothoracic diseases（atrio septal defect in 3 cases,ventricular septal defect in 4 cases,congenital lung cyst in 4 cases,diaphragmatic eventration in 1 case,neurofibromatosis of mediastinum in 1 case） which underwent simultaneous pectus deformity correction with other cardiothoracic surgeries were retrospectively analyzed.The patients were divided into 2 groups（pectus excavatum with congenital heart disease group;pectus excavatum with thoracic disease group）.The pectus deformities were corrected by using the Nuss procedure in all patients.The cardiac-thoracic surgeries were performed before the Nuss procedure.Thirty peer cases of heart diseases and 10 peer cases of pectus excavatum during the same period were randomly selected as the control group.The peri-operative Haller index,total operation duration,the volume of post-operative chest drainage,duration of post-operative chest tube,duration of post-operative mechanical ventilation and ICU were analyzed. Results Thirteen patients were cured and discharged.No major complications were found.Postoperative Haller index significantly decreased（P0.05）.There was statistical significance in the contribution of total operation duration between the group of pectus excavatum with congenital heart diseases and the control groups（Pa0.05）.There were no statistical differences in postoperative volume of chest drainage,duration of chest tube maintainance and mechanical ventilation,and duration of ICU between pectus excavatum with congenital heart disease group and congenital heart disease group.Satisfied cardiac-pulmonary function and cosmetic outcome were achieved in all patients. Conclusion Concomitant pectus deformity correction with other cardiothoracic surgery can be performed safely and eliminate the risks of a second operation in one-stage procedure.

关 键 词：漏斗胸 心胸疾病 同期手术 

分 类 号：R726.5[医药卫生—儿科]