新型矫形钢板治疗成人漏斗胸190例  

Surgical treatment of 190 adults with pectus excavatum by newly modified orthopedic steel plate

作　　者：胡丰庆[1] 王磊[1] 王明松[1] 梅举[1] 李国庆[1] HU Fengqing;WANG Lei;WANG Mingsong;MEI Ju;LI Guoqing(Department of Cardiothoracic Surgery,Xinhua Hospital,School of Medicine,Shanghai Jiaotong University,Shanghai,200092,P.R.Chin)

机构地区：[1]上海交通大学医学院附属新华医院心胸外科,上海200092

出　　处：《中国胸心血管外科临床杂志》2018年第8期687-690,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：国家自然科学基金(81602418);上海市青年科技英才扬帆计划(15YF1407800)

摘　　要：目的总结应用新型矫形钢板治疗成人漏斗胸的治疗经验。方法回顾性分析2011年1月至2016年6月我院采用具有自主知识产权的新型矫形钢板治疗190例成人漏斗胸患者的临床资料,其中男151例、女39例,年龄18~45(21.80±3.96)岁,并对治疗效果进行随访,对术前术后的Haller指数及肺功能指标进行对比分析。结果 190例患者矫形效果满意,均痊愈出院,其中12例因凹陷范围大,置入2根钢板。术后气胸7例,其中2例经胸腔穿刺抽气一次后痊愈,5例为少量气胸,无需特殊处理。5例术后出现切口愈合不良,予清创后痊愈。术后2例因局部应力过大出现钢板移位,再次手术后效果良好。手术时间36~65 min,术中失血量5~20 ml。术后住院时间4~7 d。Haller指数及肺功能均较术前明显改善(P<0.001)。结论应用新型矫形钢板治疗成人漏斗胸效果良好。Objective To summarize the clinical experience of treating adults with pectus excavatum by newly modified orthopedic steel plate and Nuss procedure. Methods The clinical data of 190 adults with pectus excavatum treated by newly modified Nuss procedure in Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine from January 2011 to June 2016 were collected. There were 151 males and 39 females aged 21.80±3.96 years ranging from 18 to 45 years. The therapeutic efficacy, Haller index and the lung function index were also analyzed. Results All patients recovered well after the operation. Two orthopedic steel plates were implanted in 12 patients.Pneumothorax was found in 7 patients postoperatively and 2 of them was treated by puncture extraction. There were 5 patients with poor healing of incision and all of them were healed after the debridement. Other complications such as steel plate shift was found in 2 patients. Both of them recovered after the reoperation. The duration of operation was 36–65 min. The intraoperative blood loss was 5–20 ml. Postoperative hospital stay was 4–7 days. Haller and lung function index improved after the operation（P〈0.001）. Conclusion It is effective and safe to treat the pectus excavatum by newly modified orthopedic steel plate and Nuss procedure in adult patients.

关 键 词：新型矫形钢板 成人漏斗胸 外科治疗 

分 类 号：R655[医药卫生—外科学]