PDS-Ⅱ线和钢丝两种固定材料在漏斗胸Nuss手术中的对比研究  

Comparative study of PDS-Ⅱsuture fixation and medical steel wire fixation in Nuss operation of pectus excavatum

作　　者：宁金波 谢义民 陈强 陈斌 刘渝 NING Jinbo;XIE Yimin;CHEN Qiang;CHEN Bin;LIU Yu(Department of Pediatric Surgery,Three Gorges Hospital Affiliated to Chongqing University,Chongqing 404000,China;Department of Pediatrics,Three Gorges Hospital Affiliated to Chongqing University,Chongqing 404000,China)

机构地区：[1]重庆大学附属三峡医院小儿外科,404000 [2]重庆大学附属三峡医院儿科,404000

出　　处：《重庆医学》2021年第5期776-779,共4页Chongqing medicine

基　　金：重庆市科学技术局技术创新与应用发展专项(cstc2020jscx-kjfp0005);重庆市万州区科技计划项目(wzstc-2018004)。

摘　　要：目的回顾性研究PDS-Ⅱ线和医用钢丝两种固定材料对小儿漏斗胸Nuss手术的效果及内固定取出术的影响。方法将该院2015年1月至2019年12月期间行漏斗胸Nuss手术矫形并行内固定取出术的先天性漏斗胸患儿47例纳入本研究,采用PDS-Ⅱ线固定者纳入观察组,采用医用钢丝固定者纳入对照组。其中观察组22例,对照组25例。将钢板移位,内固定取出术的手术时间、术中出血量、术后疼痛[面部表情分级(FRS-R)评分法]、切口感染、气胸/皮下气肿等作为风险指标,术后胸廓指数(Haller指数)作为效果指标。分析两组风险指标和效果指标的差异。结果两组各发生钢板移位1例,钢板移位率差异无统计学意义(P=1.00);观察组手术时间少于对照组[(46.8±10.1)min vs.(64.8±18.9)min,P=0.01)];观察组术中出血量少于对照组[(7.6±2.6)mL vs.(11.6±5.7)mL,P=0.016)];观察组术后FRS-R评分小于对照组[(2.68±0.65)分vs.(3.08±0.57)分,P=0.029)];气胸/皮下气肿发生率两组比较差异无统计学意义[18.2%vs.32.0%,P=0.280];两组均未发生术后切口感染。两组内固定取出术后Haller指数(2.21±0.38 vs.2.22±0.40)相近,差异无统计学意义(P=0.83)。结论在Nuss手术中应用PDS-Ⅱ线作为固定材料,胸廓矫形效果满意,内固定取出术的并发症较医用钢丝更少。Objective To retrospectively study the effects of PDS-Ⅱsuture fixation and medical steel wire fixation on Nuss operation effect and the subsequent internal fixation removal surgery.Methods Forty-seven children with congenital pectus excavatum who underwent internal fixation removal from January 2015 to December 2019 were included in this study.Those who were fixed by PDS-Ⅱline were included in the observation group(n=22).Those who were fixed with medical steel wires were included in the control group(n=25).Plate displacement,operation time of internal fixation removal,intraoperative blood loss,postoperative pain[Facial Expression Rating(FRS-R)scoring method],incision infection,pneumothorax/subcutaneous emphysema were selected as risk indicators,while Haller Index was selected as effect indicator.Statistical analysis was performed to determine the differences of these indicators between the two groups.Results One case of plate displacement occurred in each of the two groups,and the difference of plate displacement rate was not statistically significant(P=1.00).The average operation time of the observation group was shorter than that of the control group[(46.8±10.1)min vs.(64.8±18.9)min,P=0.01)],intraoperative blood loss in the observation group was less than that of the control group[(7.6±2.6)mL vs.(11.6±5.7)mL,P=0.016)],the postoperative pain score(FRS-R score)of the observation group was lower than that of the control group[(2.68±0.65)points vs.(3.08±0.57)points,P=0.029)],there was no significant difference in the incidence of pneumothorax/subcutaneous emphysema between the two groups(18.2%vs.32.0%,P=0.280).There was no incision infection in both groups.The Haller index was similar between the two groups(2.21±0.38 vs.2.22±0.40,P=0.83),and the difference was not statistically significant.Conclusion The usage of PDS-Ⅱthread as a fixation material in Nuss operation has a satisfactory effect of thoracic orthopedics,and the complications of internal fixation removal are less than that of medical steel w

关 键 词：漏斗胸 儿童 内固定取出术 NUSS手术 PDS-Ⅱ线 

分 类 号：R655[医药卫生—外科学]