微创Nuss矫治术对漏斗胸患者手术后肺功能的影响  

The influence of the minimal invasive Nuss procedure on the postoperative pulmonary function of pectus excavatum patients

作　　者：周国华[1] 陈刚[1] 谢亮 唐继鸣 贲晓松 周海榆 张冬坤 叶雄[1] 周子浩[1] 林文梁 

机构地区：[1]南方医科大学广东省人民医院广东省医学科学院胸外科,广州510080

出　　处：《中华胸心血管外科杂志》2017年第12期733-737,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：广东省自然科学基金（2014A030313636）,广东省科技计划项目（20120318090）

摘　　要：目的 研究微创Nuss矫治术对漏斗胸患者手术后肺功能的影响.方法 回顾性分析2006年8月至2014年11月期间应用微创Nuss矫治术治疗的676例漏斗胸患者资料,其中182例具备完整的术前和术后1、3年肺功能数据.按年龄分为儿童组（6～12岁,34例）、青少年组（13～18岁,80例）、成人组（〉18岁,68例）,其中71例具备完整拆除钢板后1年肺功能数据,分组为儿童组（20例）、青少年组（22例）、成人组（29例）.分析不同年龄段的患者术前、术后1、术后3年、拆除钢板后1年的肺功能指标,探讨微创Nuss矫治术对术后肺功能的影响.结果 儿童组术前、术后1年、3年肺功能均无明显差异（P〉0.05）;青少年组及成人组术后1、术后3年用力肺活量、1 s用力呼气容积较术前降低（P〈0.05）,术后1年、3年最大呼气中段流量、用力呼出肺活量50％时的流量、用力呼出肺活量75％时的流量较术前有改善（P〈0.05）;拆除钢板后1年,3组病例肺功能数据均较术前有提高,其中以儿童组肺功能改善最为明显（P〈0.05）.结论 微创Nuss矫治手术后拆板前儿童患者肺功能与术前类似,青少年及成人患者部分肺通气功能受损;拆除钢板后各年龄段患者肺通气功能均有不同程度改善,其中12岁前施行手术者肺功能改善效果最明显.Objective To study the influence of the minimal invasive Nuss procedure on the pulmonary function of post-operative pectus excavatum patients. Methods Conduct retrospective analysis on the data from 676 pectus excavatum patients who were treated by the minimal invasive Nuss procedure from August 2006 to November 2014. Wherein 182 cases have com-plete preoperative and postoperative pulmonary-function data of one year, three years. These cases were divided into 3 groups according to the age, namely, children group（ from 6 to 12 years old, 34 cases） , adolescents group（ from 13 to 18 years old, 80 cases） , adults group（ above 18 years old, 68 cases） , among which there were 71 cases with pulmonary function data of 1 year after removal of steel plate, they were divided into 3 groups in the same way,namely, children group（20 cases）, adoles-cents group（22 cases）, adults group（29 cases） . To compare and analyze the pulmonary function indicatrix of patients with dif-ferent ages in preoperative stage, 1 year, 3 years postoperative stages and 1 year after dismantling the steel plate stage, and to investigate the influence of the minimal invasive Nuss procedure on the postoperative lung function. Results The pulmonary function indicatrix in preoperative stage, 1 year, 3 years postoperative stages of the children group did not have significant difference（P〉0. 05）; the FVC, FEV1 indicatrix of adolescents and adults groups declined after operation in 1 year and 3 years compared with the preoperative stage（P〈0. 05）, FEF 25％ -75％, FEF 50％, FEF75％ were improved after operation in 1 year and 3 years compared with the preoperative stage（P〈0. 05）;the pulmonary function indicatrix of three age groups in the 1 year after dismantling the steel plate stage had all improved, in which the pulmonary function indicatrix of the children group improves most significantly（P〈0. 05）. Conclusion After the minimal invasive Nuss procedure before the plate dis-mantling process, the pulmonary fu

关 键 词：漏斗胸 微创NUSS手术 肺功能 

分 类 号：R655.1[医药卫生—外科学]