先心病术后漏斗胸的Nuss手术治疗策略  

Treatment strategy of Nuss procedure for pectus excavatum after operation for congenital heart disease

作　　者：李帅[1] 汤绍涛[1] 曹国庆[1] 阳历[1] 普佳睿[1] 李康[1] 张茜[1] 王勇[1] 毛永忠[1] 童强松[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院小儿外科

出　　处：《临床外科杂志》2015年第11期819-820,共2页Journal of Clinical Surgery

摘　　要：目的：探讨应用 Nuss 手术治疗先天性心脏病（congenital heart disease，CHD）术后漏斗胸的治疗策略。方法 CHD 术后漏斗胸患儿36例，胸骨后粘连轻的28例患者采用经典胸腔镜Nuss 手术，胸骨后粘连重的8例患者采用采用胸腔镜 Nuss 手术结合剑突下辅助切口治疗。观察并记录其手术时间、住院时间、手术效果、术中及术后并发症。结果手术时间65~86分钟，平均（71.1±5.6）分钟；住院时间5~13天，平均（7.2±1.5）天；术中心包穿破1例，心脏破裂术中死亡1例，手术初期效果评价优良率100.0％。结论 Nuss 手术是治疗 CHD 术后漏斗胸的一种有效方法，但仍需进一步完善。Objective To explore the feasibility and efficacy of Nuss procedure for pectus exca-vatum after operation for congenital heart disease（CHD）. Method A total of 36 cases of postoperative pectus excavatum were enrolled. Patients with mild substernal adhesion underwent classic Nuss procedure and the others with severe substernal adhesion underwent improved Nuss procedure with subxiphoid inci-sion. The operative time,hospital stay,operation result and complications were reviewed and analyzed. Re-sults There were 28 cases of classic procedure and 8 cases of improved procedure. Operative time ranged from 65 to 86 min,with an average of（71. 1 ± 5. 6） min. Hospital stay ranged from 5 to 13 d,with an average of（7. 2 ± 1. 5） d. Intraoperative complications included one case of ruptured pericardium and one case of cardiac rupture. The ratio of good early effect was 100% . Conclusion Nuss procedure is an effective treatment for pectus excavatum after operation for congenital heart disease. Further improvement is still required.

关 键 词：漏斗胸 心脏病 心脏外科手术 微创手术 

分 类 号：R726.5[医药卫生—儿科]