不同手术方式治疗小儿漏斗胸的疗效比较  

Efficacies of single-incision Nuss procedures for pectus excavatum

作　　者：宁金波 谢义民[1] 陈强[1] Ning Jinbo Xie Yimin Chen Qiang.(Department of Pediatric Surgery, Three Gorges Central Hospital, Chongqing 404000, China)

机构地区：[1]重庆三峡中心医院小儿外科,重庆市404000

出　　处：《临床小儿外科杂志》2017年第3期262-265,共4页Journal of Clinical Pediatric Surgery

摘　　要：目的探讨经单切口实施NUSS手术治疗小儿漏斗胸的安全性及临床疗效。方法本院2014年2月至2015年10月实施NUSS手术治疗小儿漏斗胸47例(Park分型均为I型,Haller指数3.3~4.1),其中经单切口手术(观察组)25例,经双侧切口手术(对照组)22例。对两组在手术时间、术中出血、住院时间、并发症、疼痛强度和疗效等方面进行对比分析。平均随访时间为11个月(6~26个月)。结果 47例均顺利完成手术,无一例死亡,治疗优良率均为100%。从围手术期情况来看,观察组手术时间(52.96±7.17)min,术中出血量(7.08±3.23)mL,疼痛强度评分为3.64±1.03;对照组手术时间(67±9.28)min,术中出血量(9.91±4.12)mL,疼痛强度评分4.22±0.81。经统计学分析两组各项差异均有统计学意义(P值均<0.05)。并发症方面比较,两组各有2例出现气胸,经观察后均自行吸收,观察组中3例术后出现长期疼痛,对照组2例术后出现长期疼痛,均予去痛片口服对症处理后好转,两组并发症的发生率比较差异无统计学意义(x^2=0.16,P=0.69)。结论经单切口实施NUSS手术治疗小儿对称性漏斗胸损伤小,手术时间短,出血少,疼痛轻,是可行的、安全可靠的方法,近期临床效果满意。Objective To explore the efficacy and safety of single-incision Nuss procedure for pectus excavatum. Methods A total of 47 cases with pectus excavatum treated by Nuss procedures from February 2014 to October 2015 were selected. All cases belonged to type I according to Park criteria. The Hailer index was 3.3 - 4. 1. Observation group （n = 25） consisted of patients undergoing one incision surgery while control group （n = 22） was operated with double incisions. The duration of surgery, blood loss, duration of hospitaliza- tion, complications and pain intensity were compared and analyzed. The mean follow-up period was 11 （6 - 26） months. Results All operations were completed successfully. Age at surgery, weight, height, duration of hos- pitalization, complications and efficacy did not differ between two groups. In observation group, operative dura- tion, blood loss and pain intensity were lower than those in control group. Duration of hospitalization, complica- tions or efficacy did not differ between two groups. Conclusions Single-incision Nuss procedure is feasible, safe and reliable for pectus excavatum. It has the advantages of smaller trauma, shorter operative duration and minimal blood loss. The immediate chnical efficacy is satisfactory.

关 键 词：漏斗胸 NUSS手术 治疗 儿童 

分 类 号：R726.5[医药卫生—儿科]