非胸腔镜下Nuss手术矫治漏斗胸的40例临床分析  

Correction of pectus excavatum by non-thoracoscopic Nuss procedure in 40 patients

作　　者：梁江水[1] 陈宏旺 马忠厦[1] 代传宙[1] 柴燕飞 崔鑫鹏[1] 肖跃华[1] Liang Jiangshui;Chen Hongwang;Ma Zhongsha;Dai Chuanzhou;Chai Yanfei;Cui Xinpeng;Xiao Yuehua(Department of Thoracic Surgery,South Branch of Chenzhou First People’s Hospital,Chenzhou 423000,China)

机构地区：[1]郴州市第一人民医院南院胸外科,423000

出　　处：《国际医药卫生导报》2020年第11期1553-1556,共4页International Medicine and Health Guidance News

摘　　要：目的总结非胸腔镜下Nuss手术矫治漏斗胸的临床经验。方法2012年10月至2019年5月,手术治疗40例漏斗胸患者中男36例,女4例;年龄范围3~16岁,年龄(8.7±2.4)岁。术前CT示Haller指数(4.75±1.6)。所有病例均施行非胸腔镜下Nuss微创手术。结果所有患儿均顺利完成手术,围手术期均无大出血、脏器损失及死亡等严重并发症发生。手术时间25~55(34±16)min;术后住院时间5~7(5.5±1.2)d;术中出血量5~10 ml。术后3例出现左侧胸腔少量积液,1例出现右侧气胸(少量),均保守治疗治愈。随访3个月~4年,近期疗效评定均为疗效满意40例,无疗效不满意者,1例术后2个月出现支撑钢板过敏,切开引流换药,长期不愈,于术后1.5年手术取出矫形板。32例患者于Nuss术后2~4年取出矫形钢板,矫形钢板取出术后随访3个月~1年,均无漏斗胸复发现象。结论非胸腔镜下Nuss手术矫正漏斗胸创伤小、恢复快、并发症少且安全性高,近中期疗效确切,易于在基层医院应用推广。Objective To summarize clinical experience of minimally invasive non-thoracoscopic Nuss procedure for the treatment of pectus excavatum(PE).Methods Forty pediatric patients,including 36 males and 4 females,with the average age of(8.7±2.4)years old,received minimally invasive non-thoracoscopic Nuss surgery for PE between October 2012 and May 2019 in Department of Thoracic Surgery.The Haller index of preoperative CT was(4.75±1.6).Results Deformities of all the patients were successfully corrected.No serious complications such as massive hemorrhage,organ loss,or death occurred during the perioperative period.The operating time was ranged from 25 to 55 minutes[(34±16)minutes].The hospital stay was ranged from 5 to 7 days[(5.5±1.2)days].The intraoperative blood loss was 5-10 ml.Postoperative complications were as following:3 patients with small amount of pleural effusion on the left side;1 patient with mild pneumothorax on the right side.All of the postoperative complications were cured by conservative treatment.All the patients were followed up for 3 months to 4 years.The curative effects of all the patients were satisfactory.Supporting plate allergy occurred in 1 patient 2 months after the Nuss procedure,which was removed by reoperation at 1.5 years after the first surgery after the failed treatment of incision drainage.32 patients underwent the operation for removing supporting plate 2-4 years after the Nuss procedure.There was no recurrence of PE during follow up for 3 months to 1 year after reoperation.Conclusion Non-thoracoscopic Nuss procedure for the treatment of PE was easily applied in basic-level hospitals with the advantage of less trauma,rapid recovery,less complications,and high safety.

关 键 词：漏斗胸 NUSS手术 非胸腔镜 

分 类 号：R726.5[医药卫生—儿科]