基于漏斗胸Nuss术后钢板置入期间胸廓外形矫形评价及相关因素分析  

Based on orthopedic evaluation of thoracic shape and related factors during the steel plate implantation of pectus excavatum after Nuss surgical operation

作　　者：卞军[1] 施伟栋[1] 丁文泽 蔡慧强 张向宁[1] 魏强[1] 陈伯林[2] 王渝忻 赵帅宇 Bian Jun;Shi Weidong;Ding Wenze;Cai Huiqiang;Zhang Xiangning;Wei Qiang;Chen Bolin;Wang Yuxin;Zhao Shuaiyu(Department of General Surgery,Xi'an Children's Hospital,Children's Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710003,China;Northwestern Polytechnical University,School of Computer Science,Xi'an 710072,China)

机构地区：[1]西安市儿童医院、西安交通大学附属儿童医院普外一科,西安710003 [2]西北工业大学计算机学院,西安710072

出　　处：《中华胸心血管外科杂志》2023年第10期610-614,共5页Chinese Journal of Thoracic and Cardiovascular Surgery

摘　　要：目的通过漏斗胸患儿Nuss术后钢板置入期间胸廓外形矫形评价,探讨并分析Nuss术前相关因素对术后矫形评价的影响。方法2012年4月至2019年4月,西安市儿童医院接收Nuss手术的漏斗胸患者159例,年龄3.2~17.0岁,平均(6.8±3.4)岁;男124例,女35例;Haller指数2.7~7.5,平均(4.0±1.0);其中6例(4%)术后胸廓外形矫形评价差,男5例,女1例;23例(14%)术后胸廓外形矫形评价良,男16例,女7例;130例(82%)术后胸廓外形矫形评价优,男103例,女27例。随访至少2年。回顾性分析术后胸廓矫形评价与患儿的年龄、性别、Haller指数、手术中钢板放置的方式、漏斗胸对称与否的关系,并采用t检验和χ^(2)检验对其进行统计学分析。结果漏斗胸术后胸廓矫形评价与漏斗胸分型统计学分析显示差异有统计学意义(P=0.001),即不对称漏斗胸术后矫形评价差;患者性别、Haller指数、手术中钢板放置方式差异无统计学意义(P>0.05);但随着年龄减小,矫形评价逐渐变差,随着Haller指数增加,矫形评价开始变差。结论不对称漏斗胸患儿是Nuss术后钢板置入期间矫形评价差的主要风险因素,特别是小年龄患儿和Haller指数较大的患儿。Objective To explore the incidence and factors of the influence of preoperative related factors on postoperative orthopedic evaluation,through the evaluation of thoracic shape orthopedic evaluation of children pectus excavatum,during plate implantation after Nuss procedure.Methods From April 2012 to April 2019,the clinical data were analyzed retrospectively for 159 hospitalized cases of Nuss procedure for pectus excavatum in Xi’an Children’s Hospital.The mean age was(6.8±3.4)years old(3.2-17.0 years old);males 124,females 35;Haller index 4.0±1.0(2.7-7.5);6 cases(4%)were poor orthopedic evaluation with the thoracic shape,males 5,femal 1;23 cases(14%)were average satisfied with the thoracic shape,males 16,femals 7;130 cases(82%)were good orthopedic evaluation with the thoracic,males 103,femals 27.Follow-ups were conducted for at least 2 years,Retrospective analysis of the relationship between postoperative thoracic satisfaction and age,gender,Haller index,how the plates were placed during surgery and symmetry of funnel chest,t test andχ^(2) test were used for statistical analysis.Results There were statistically significant differences between thoracic orthopedic evaluation after postoperative and classification of pectus excavatum(P=0.001),and poor orthopedic evaluation after asymmetric pectus excavatum operationand;There were no significant differences in gender,Haller index,surgical method and how the plates were placed during surgery(P>0.05).However,it can be seen from the mean and percentage that with the decrease of age,and the increase of Haller index,the orthopedic evaluation gradually becomes worse.Conclusion According to our single-center study,asymmetric pectus excavatum is a factor for poor orthopedic evaluation during plate implantation after Nuss,especially for young children and children with larger Haller index.

关 键 词：漏斗胸 术后 胸廓外形 矫形评价 风险因素 

分 类 号：R726.5[医药卫生—儿科]