微创Nuss手术在胸壁畸形治疗中的临床应用研究  

Clinical Application of Nuss Minimally Invasive Surgery in the Treatment of Chest Wall Deformity

作　　者：吴家宝[1] 钟金慧 邓江波[1] 王楚华[1] 

机构地区：[1]广东省英德市人民医院,广东英德513000

出　　处：《中国医学创新》2016年第18期105-108,共4页Medical Innovation of China

基　　金：清远市科技计划项目医疗卫生领域自筹经费(1500)

摘　　要：目的：对微创Nuss手术在胸壁畸形治疗中的临床应用进行分析探讨。方法：收集整理本院2010年1月-2015年7月收治的采用微创Nuss手术治疗的小儿胸壁畸形患者共19例进行研究分析,其中漏斗胸10例,鸡胸9例。结果：本研究的19例患儿均顺利完成了Nuss手术,其胸壁畸形的情况得到满意矫正,手术时间为40~70 min,手术后住院时间5~9 d。术后1例出现气胸（小于患儿总数的10%,未予特殊处理）,该患儿的气胸状况在术后3 d消失,另外1例患儿出现轻度皮下气肿。术后随访1个月~3年,其中1例患儿在初次手术的3个月后由于钢板移位进行了二次手术,另外1例患儿在出院后的第2周出现了右侧胸腔积液,经抗感染及右侧胸腔穿刺后积液消失,情况得到控制。剩余患儿在手术中以及住院期间和术后随访时均未出现不适症状,其中2例患儿在术后3年取出钢板,畸形矫治结果满意。结论：微创Nuss手术在治疗小儿胸壁畸形的应用过程中,具有创伤小、恢复快等优点,患者及其家属对畸形矫治满意,该方法安全可行,值得在临床治疗中加以大力推广应用。Objective： To discuss the clinical application of Nuss minimally invasive surgery in the treatment of chest wall deformity.Method： From January 2010 to July 2015, a total of 19 pediatric patients with chest wall deformity were analyzed using Nuss minimally invasive surgical, and were set up the observation group. Funnel chest 10 cases, pigeon breast 9 cases.Result： 19 cases were successfully completed the Nuss procedure, the chest wall deformity correction got satisfied, the operating times were 40-70 minutes, children in hospital times were 5-9 days after surgery.1 case was pneumothorax （less than 10% of the total number of children, not special treatment ）, the condition of children with pneumothorax disappeared 3 days after operation.In addition, 1 patient appeared mild subcutaneous emphysema.After surgery were followed up for 1-3 months, including 1 case in the first 3 months after the surgery due to the displacement of steel plate for the second operation.In addition, 1 case appeared right pleural effusion at the second week after discharge, the resistance to infection, and right pleural effusion disappeared after puncture, situation was under control.Remaining few cases during surgery and at the time of hospital stay and postoperative follow-up were not present symptoms, including 2 cases of children with 3 years after surgery to take out the steel plate, the deformity correction results were satisfactory. Conclusion ： Nuss minimally invasive surgery in the treatment the application process of infantile chest wall deformity, has the advantages of small trauma, rapid recovery, patients and their families satisfied with deformity correction, this method is safe and feasible, is worth of promoting application in clinical treatment.

关 键 词：微创NUSS手术 胸壁畸形 手术治疗 

分 类 号：R726.5[医药卫生—儿科]