[1]冉旭东,沈维嘉,李炘,等.青少年鸡胸的微创手术治疗探讨[J].临床小儿外科杂志,2023,22(06):529-532.[doi:10.3760/cma.j.cn101785-202210052-006]
　Ran Xudong,Shen Weijia,Li Xin,et al.Mini-invasive inverted Nuss procedure for correcting pectus carinatum[J].Journal of Clinical Pediatric Surgery,2023,22(06):529-532.[doi:10.3760/cma.j.cn101785-202210052-006]
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青少年鸡胸的微创手术治疗探讨

《临床小儿外科杂志》[ISSN:1671-6353/CN:43-1380/R] 卷: 第22卷 期数: 2023年06 页码: 529-532 栏目: 专题·儿童胸壁畸形的诊治 出版日期: 2023-06-28
Title:
Mini-invasive inverted Nuss procedure for correcting pectus carinatum
作者:
冉旭东;  沈维嘉;  李炘;  廖健毅;  袁洪樑;  王淏;  吴松华
苏州大学附属儿童医院心胸外科, 苏州 215000
Author(s):
Ran Xudong;  Shen Weijia;  Li Xin;  Liao Jianyi;  Yuan Hongliang;  Wang Hao;  Wu Songhua
Department of Cardiothoracic Surgery, Affiliated Children’s Hospital, Soochow University, Suzhou 215000, China
关键词:
鸡胸; 矫形外科手术; 最小侵入性外科手术; 治疗结果; 手术后并发症; 青少年
Keywords:
Pectus Carinatum; Orthopedic Procedures; Minimally Invasive Surgical Procedures; Treatment Outcome; Postoperative Complications; Adolescent
DOI:
10.3760/cma.j.cn101785-202210052-006
摘要:
目的 总结微创手术（反Nuss手术，又称微创胸骨沉降术）治疗青少年鸡胸的手术经验及临床疗效。方法 回顾性分析苏州大学附属儿童医院心胸外科2020年7月至2021年12月采用微创反Nuss手术治疗的15例青少年鸡胸患儿临床资料。其中男14例，女1例；年龄11岁9个月至15岁，中位年龄13岁3个月；体重36~55 kg，中位值44 kg；Hailer指数1.76~2.24，中位值1.94。均采用将Nuss手术钢板置于胸骨前以及钢丝固定两侧尾端于肋骨对胸骨施压的方法。9例采用反Nuss手术，6例采用反Nuss手术+Nuss手术，收集所有患儿手术情况及治疗结果。结果 15例均顺利完成手术，无一例出现术中脏器损伤。手术时间70~225 min，中位时间100 min；术后住院时间5~7 d；钢板放置时间1年6个月。分别于术后1个月、3个月、6个月、12个月进行随访。1例术后1个月胸骨塌陷，摘除钢板后复发。1例术后3个月剧烈运动后一侧钢丝断裂，再次手术固定钢板。结论 反Nuss手术治疗鸡胸创伤小，恢复快，疗效满意。最佳手术矫正时机为13岁左右。但手术技巧及中远期疗效的评价，还有待更多病例的经验积累以及更长时间的随访来验证。
Abstract:
Objective To explore the surgical approaches, outcomes and complications of mini-invasive inverted Nuss procedure for correcting pectus carinatum (PC) in children.Methods From July 2020 to December 2021, retrospective anlysis was performed for clinical data of mini-invasive inverted Nuss procedure for correcting PC.There were 14 boys and 1 girl with a median age of 19.6(141-180) month and a median weight of 44(36-55) kg.Hailer index had a median value of 1.94(1.76-2.24).Steel bar was pressed anteriorly onto sternum via a lateral thoracic incision and fixed with steel wires.Inverted Nuss procedure was performed alone (n=9) and with Nuss procedure (n=6).Results All procedures were successfully completed without intraoperative complications.The median operative duration was 100(70-225) min and the length of postopretive stay (5-7) day.The bar was implanted for 1.5 years.Follow-ups were conducted at Month 1/3/6/12.One case recurred due to sternal callapse at Month 1 post-operation.Another child was reoperated for break of steel wire during vigorous exercise at Month 3 post-operation.Conclusion Inverted Nuss procedure may correct PC with minimal injury and a quick recovery.Its middle/long-term outcomes should be evaluated by a larger sample size and longer follow-ups.

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备注/Memo

收稿日期:2022-10-25。
基金项目:苏州市儿童结构畸形重点实验室（SZS2022018）
通讯作者:冉旭东,Email:rxdsz_2004@126.com

更新日期/Last Update: 1900-01-01