摘要
目的探讨在Nuss手术中采用斜行放置钢板矫治大龄儿童漏斗胸的可行性和手术技巧。方法回顾性分析西安市儿童医院普外一科自2017年6月至2018年12月收住的23例大龄漏斗胸患儿的临床资料。其中,男17例,女6例;年龄10~17岁,平均13岁。在NUSS手术中均采用斜行放置钢板,其中合并扁平胸的4例,增加一横行放置钢板,术后门诊长期随访。结果23例患儿手术均顺利完成,手术时间为(60±15)min,术中失血量为(6±3)ml。术中出现肋间肌撕裂1例,重新选择钢板出入点。术后住院时间为(6±1)d,无钢板移位及伤口感染等并发症,效果良好。本组患儿术后均采用门诊复查随访,随访时间为10~28个月。术后双侧肋缘增高2例,给予支具下压恢复;另1例钢板一侧下压赫氏沟力量过大,引起赫氏沟轻度内陷,目前随访观察中。手术随访效果评估,优良22例(96%),中1例(4%)。结论大龄漏斗胸患儿采用钢板斜行放置安全有效,值得在临床推广。
Objective To explore the feasibility of Nuss procedure with oblique placement for correcting pectus excavatum in elder children.Methods From June 2017 to December 2018,23 elder children of pectus excavatum were selected.There were 17 boys and 6 girls with a mean age of 13(10-17)years.Nuss procedure was performed for correcting pectus excavatum by oblique placement.Four cases of flat chest were implanted with an extra horizontal brace.Long-term postoperative clinic follow-ups were conducted.Results All 23 cases were successfully completed.The mean operative duration was(60±15)min and intraoperative blood loss(6±3)ml.For one case of intraoperative intercostal muscular avulsion,the plate entry-and-exit points were re-selected.The mean postoperative hospitalization stay was(6±1)days.Bilateral costal margins increased postoperatively in 2 cases and reverted after supporting.Mild Harrison groove depression occurred due to unilateral pressure of steel plate.During a follow-up period of 10-28 months,the postoperative outcomes were excellent(n=22,96%)and moderate(n=1,4%).Conclusions Oblique plating is safe and efficacious for correcting pectus excavatum in elder children during Nuss procedure.
作者
卞军
施伟栋
Bian Jun;Shi Weidong(Department of Thoracic Surgery,Children's Hospital of Xi'an Jiaotong University,Xi'an Children's Hospital,Xi'an 710003,China)
出处
《中华小儿外科杂志》
CSCD
北大核心
2020年第9期784-787,共4页
Chinese Journal of Pediatric Surgery
关键词
漏斗胸
胸腔镜
儿童
Funnel Chest
Thoracoscope
Child
