改良Nuss术治疗小儿漏斗胸效果及术后并发症影响因素分析  

Analysis of Effect of Modified Nuss in the treatment of Children's Funnel Chest Effect and Postoperative Complications

作　　者：李继斌[1] 孙玉芳[1] LI Jibin;SUN Yufang(Affiliated Hospital of Jining Medical College, Shandong Jining 202029, China)

机构地区：[1]济宁医学院附属医院外科,山东济宁202029

出　　处：《河北医学》2020年第8期1312-1316,共5页Hebei Medicine

基　　金：山东省济宁市科技局计划项目,(编号:[2016]56号-38)。

摘　　要：目的:分析改良微创漏斗胸矫形术(Nuss)治疗小儿漏斗胸的效果及导致术后并发症的影响因素。方法:回顾性分析2016年2月至2018年2月我院行Nuss术患儿90例作为研究对象,观察手术效果,并根据患儿术后是否发生并发症进行分组,采用单因素分析患者一般资料,将具有统计学意义指标纳入多因素Logistic回归中,分析导致并发症发生的独立危险因素。结果:90例患儿手术均顺利完成,共有21例患儿出现术后并发症,但经过相应处理后出院时已无大碍。患儿均得到随访,随访期间患儿无明显不适,均未出现钢板移位的发生。单因素分析显示:年龄、漏斗胸是否对称、置入钢板数量、手术时间为导致发生并发症的影响因素,差异具有统计学意义(P<0.05)。多因素Logistic回归显示:手术时间过长、非对称漏斗胸、置入钢板数1块是导致患者发生并发症的独立危险因素,差异具有统计学意义(P<0.05)。结论:Nuss手术对治疗小儿漏斗胸具有较好效果,手术时间过长、非对称漏斗胸、置入钢板数1块为导致术后并发症的独立危险因素,临床中对于该类型患儿需高度关注,防止因上述因素导致严重并发症。Objective:To analyze the effect of modified minimally invasive funnel chest correction(Nuss)in the treatment of children's funnel chest and the factors that lead to postoperative complications.Methods:From February 2016 to February 2018,90 children undergoing Nuss operation in our hospital were analyzed retrospectively.the results were observed and divided into groups according to whether the complications occurred after operation.The general data of patients were analyzed by univariate analysis.The statistically significant indexes were included in multivariate Logistic regression,and the independent risk factors leading to complications were analyzed.Results:The operation was successfully completed in 90 cases.A total of 21 cases had postoperative complications,but after corresponding treatment,there was no serious problem when they were discharged from hospital.All the children were followed up.During the follow-up period,there was no obvious discomfort and no plate displacement occurred.Univariate analysis showed that age,the symmetry of funnel chest,the number of plates inserted and the time of operation were the influencing factors of complications,and the difference was statistically significant(P<0.05).Multivariate Logistic regression showed that the operation time was too long,asymmetric funnel chest and the number of plates placed was an independent risk factor for complications,and the difference was statistically significant.Learning significance(P<0.05).Conclusion:Nuss operation has a good effect on the treatment of pectus excavatum in children.The long operation time,asymmetric pectus excavatum and the number of plates placed are independent risk factors for postoperative complications.In clinical practice,high attention should be paid to this type of children to prevent serious complications caused by the above factors.

关 键 词：微创漏斗胸矫形术 漏斗胸 并发症 影响因素 

分 类 号：R72[医药卫生—儿科]