非胸腔镜辅助Nuss手术治疗漏斗胸51例分析  

Correction of Pectus Excavatum by Non-thoracoscopic Nuss Procedure in 51 Patients

作　　者：刘玉[1] 邹志强[1] 杨露[2] 李传海[1] 

机构地区：[1]济南军区总医院胸外科,济南250031 [2]济南儿童医院儿科,济南250022

出　　处：《中国胸心血管外科临床杂志》2015年第2期139-142,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

摘　　要：目的总结非胸腔镜辅助微创Nuss手术治疗漏斗胸的临床经验。方法 2008年7月至2014年2月济南军区总医院胸外科采用非胸腔镜辅助微创Nuss手术治疗51例漏斗胸患儿,其中男32例、女19例,年龄8.32（2.5~17.0）岁。全组均采用双侧胸壁横行切口,将矫形板由左胸壁经胸骨后穿至右胸壁,翻转矫形板并固定于肋骨完成矫正。结果全组患者畸形均得以矫正,手术时间为30~52（38±9）min。其中1例发生心脏损伤,开胸修补成功后放置支撑钢板。术后发生皮下气肿7例、气胸3例、肺不张3例,经保守治疗后痊愈。术后4个月支撑钢板移位1例,再次手术矫正。随访1~42（21.6±7.6）个月,依据Nuss效果评价标准评价优39例,良9例,中3例。结论非胸腔镜辅助微创Nuss手术矫正小儿漏斗胸的矫形效果确切,并发症少,简便可行,安全有效。Objective To summarize clinical experience of minimally invasive non-thoracoscopic Nuss procedure for the treatment of pectus excavatum（PE）. Methods Fifty-one pediatric patients received minimally invasive nonthoracoscopic Nuss procedure for PE between July 2008 and February 2014 in Department of Thoracic Surgery, Jinan Military General Hospital. There were 32 males and 19 females with their average age of 8.32（2.5-17.0） years. Transverse incisions were made in bilateral chest wall. Supporting plate was put to right chest wall through retrosternal approach, turned over and fastened onto the ribs. Results Deformity of all the patients was successfully corrected. Operation time was 30-52（38±9） minutes. One patients had heart injury which was repair after open thoracotomy, and then supporting-plate was successfully secured. Postoperative complications included subcutaneous emphysema in 7 patients,pneumothorax in 3 patients and atelectasis in 3 patients, all of whom were cured by conservative treatment. Supportingplate transposition occurred in 1 patient and was corrected by reoperation. All the patients were followed up for 1-42（21.6±7.6） months. According to Nuss standard, there were 39 patients with excellent results, 9 patients with good results, and 3 patients with fair results. Conclusion Minimally invasive Nuss procedure is an efficacious, easy, feasible and safe procedure for the treatment of PE with low morbidity.

关 键 词：漏斗胸 微创NUSS手术 非胸腔镜辅助 

分 类 号：R655[医药卫生—外科学]