Xu Huijiao,Lai Guanyu,Jiang Qin,et al.Clinical analysis of Nuss procedure for extremely severe pectus excavatum:a report of 93 cases[J].Journal of Clinical Pediatric Surgery,2026,(09):847-851.[doi:10.3760/cma.j.cn101785-202509020]
Nuss手术矫治极重度漏斗胸93例临床分析
- Title:
- Clinical analysis of Nuss procedure for extremely severe pectus excavatum:a report of 93 cases
- Keywords:
- Pectus Excavatum; Nuss Procedure; Complications
- 摘要:
- 目的 探讨 Nuss手术治疗极重度漏斗胸患者中的手术策略、安全性及近中期疗效。方法 回顾性分析2010年6月至2023年1月四川省人民医院小儿外科收治的93例极重度漏斗胸患儿的临床资料，均采用Nuss手术矫治。根据畸形特征采用不同手术方式，包括钢板植入数量、钢丝固定、剑突下辅助切口或肋弓切断等技术。结果 93例均顺利完成手术，无一例术中严重并发症。手术耗时（75.3±8.3）min，出血量（30.0±5.2）mL，住院时间（7.1±1.1）d。双钢板植入75例 （80.6%），单钢板18例（19.4%）；65例（69.9%）加用钢丝固定，5例（5.4%）行肋弓切断。术后并发症发生率 29.0%。随访14～48个月，已拆除钢板66例。手术效果评估优90例（96.8%），良3例 （3.2%），无一例中及差者。结论 Nuss手术治疗极重度漏斗胸安全可行，近中期疗效满意，但远期效果仍需进一步随访。
- Abstract:
- Objective To explore the surgical strategies,safety and short/middle-term efficacy of Nuss procedure for extremely severe pectus excavatum.Methods A retrospective analysis was performed for the relevant clinical data of 93 children with extremely severe pectus excavatum admitted into Department of Pediatric Surgery at Sichuan Provincial People’s Hospital from June 2010 to January 2023.All cases underwent Nuss surgery for correction.Different surgical approaches were adopted according to the characteristics of deformities,including number of steel plate implants,wire fixation,subxiphoid auxiliary incisions or costal arch division techniques.All procedures were successfully completed without any serious intraoperative complications.Results Operative duration was (75.3±8.3) minutes,volume of blood loss (30.0±5.2) mL and a hospitalization stay of (7.1±1.1) day.Double plate implantation (n=75,80.6%) and single plate implantation (n=18,19.4%) were performed.And 65 cases (69.9%) were fixed with steel wire and 5 cases (5.4%) underwent rib arch cutting.The incidence of postoperative complications was 29.0%.During a follow-up period of 14 to 48 months,66 cases of steel plates have been removed.90 cases (96.8%) had excellent surgical outcomes,3 cases (3.2%) had good outcomes and there were no cases of moderate or poor outcomes.Conclusion For extremely severe pectus excavatum,Nuss procedure is both safe and feasible with satisfactory short/mid-term efficacy.However,further follow-ups are required for evaluating the long-term outcomes.
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备注/Memo
收稿日期:2025-9-10。
基金项目:四川省天府万人计划天府名医资助项目(TF005)；四川省科技厅重点资助项目(2021YFS0381)；四川省医学科学院·四川省人民医院专项基金资助项目(2021ZX03）
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