负压吸盘对漏斗胸患者前胸皮下脂肪的影响  

Effect of vacuum bell therapy on subcutaneous fat of chest wall in patients with pectus excavatum

作　　者：张谦 曾骐[1] 陈诚豪[1] 于洁[1] 张娜[1] Zhang Qian;Zeng Qi;Chen Chenghao;Yu Jie;Zhang Na(Department of Thoracic Surgery,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Key Laboratory of Major Diseases in Children,Ministry of Education,National Clinical Research Center for Respiratory Disease,Beijing Engineering Research Center of Pediatric Surgery,Beijing 100045,China)

机构地区：[1]国家儿童医学中心、首都医科大学附属北京儿童医院胸外科、儿科重大疾病研究教育部重点实验室、国家呼吸系统疾病临床医学研究中心、北京市儿童外科矫形器具工程技术研究中心,北京100045

出　　处：《中华胸心血管外科杂志》2024年第11期654-656,共3页Chinese Journal of Thoracic and Cardiovascular Surgery

基　　金：北京市科学技术委员会首都临床诊疗技术研究及转化应用项目(Z211100002921034)。

摘　　要：目的漏斗胸患儿使用负压吸盘后会使胸前皮下脂肪增厚,本研究探讨这种脂肪增厚带来的影响。方法回顾性分析我中心2022年1~6月使用负压吸盘治疗漏斗胸的患儿。治疗开始及治疗1年时行胸部CT检查,测量治疗前后的Haller指数(HI)、前胸壁脂肪厚度、侧胸壁脂肪厚度、骨性凹陷深度、体表凹陷深度。通过治疗前后的对比计算HI好转率,反映真实的吸盘治疗效果。通过测量治疗前后脂肪厚度的变化计算吸盘影响率,反映吸盘对于前胸脂肪生长的促进程度。结果共入组41例患儿,中位年龄6.4岁(1~14岁)。负压吸盘治疗前后HI分别为3.6±0.7和3.2±0.5,10例患儿治疗后HI加重,真实吸盘治疗有效率75.6%。39例前胸壁皮下脂肪增厚,使用前后前胸壁脂肪厚度分别为(4.0±1.9)mm和(7.5±3.2)mm,吸盘影响率100%(33%~267%)。治疗前后骨性凹陷深度和体表凹陷深度分别改善(1.7±3.9)mm和(4.0±3.3)mm。结论使用负压吸盘会使胸前脂肪增加,仅通过体表测量方式评估漏斗胸会掩盖凹陷真实情况。与骨性胸壁的提升相比,凹陷区脂肪的增加会给外观带来额外的改善。Objective The thickness of subcutaneous fat of the chest wall treated with vacuum bell can cover up the true depression in patients with pectus excavatum,when measured only from the body surface.The purpose of this study was to investigate the impact of this thickness of fat on treatment evaluation.Methods Patients treated with vacuum bell from January to June 2022 in our center were retrospectively analyzed.The Haller index(HI),anterior chest wall fat thickness(A),lateral chest wall fat thickness(L),depth of body surface depression(SD),and depth of bone depression(BD)were measured by CT at the beginning of treatment and 1 year after treatment.The influence rate of vacuum bell was calculated by measuring the change of fat thickness before and after treatment to reflect the influence of vacuum bell on the growth of fat.Results A total of 41 patients were enrolled,with a median age of 6.4 years old(1-14 years old).The mean HI before and after treatment was 3.6±0.7 and 3.2±0.5,and the Haller index of 10 cases was still aggravated after treatment,and the effective rate of real suction cup treatment was 75.6%.The subcutaneous fat of the anterior chest wall was thickened in 95.1%(39 cases)patients,and A before and after treatment was(4.0±1.9)mm and(7.5±3.2)mm respectively.The average influence rate of vacuum bell was 100%(33%-267%).The mean improvement of BD and SD before and after treatment was(1.7±3.9)mm and(4.0±3.3)mm respectively.Conclusion The use of vacuum bell will thicken the fat of chest wall,and only evaluating by measuring the body surface will cover up the true depression.Compared to the lift of the sternum and ribs,the increase of the fat in depression area will give an additional improvement in appearance.

关 键 词：漏斗胸 负压吸盘 皮下脂肪 

分 类 号：R726.5[医药卫生—儿科]