摘要
目的比较不同切口胸腔镜漏斗胸微创矫正(Nuss)手术治疗小儿漏斗胸的临床效果。方法前瞻性随机对照研究2019年12月至2021年12月郑州大学第一附属医院收治的64例小儿漏斗胸患儿。依据随机数字表法分为对照组与观察组,每组32例。对照组采用剑突下小切口辅助胸腔镜Nuss手术,观察组采用经腋中线直切口辅助胸腔镜Nuss手术。比较两组患儿手术相关指标、矫形效果,术前和拔除钢板后1个月时心功能指标[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)]及两组患儿术后并发症发生情况。结果对照组手术时间长于观察组,术中失血量多于观察组,矫形效果差于观察组(P<0.05)。两组拔除钢板后1个月时LVEDD、LVEF、LVESD水平高于术前(P<0.05)。对照组术后并发症总发生率高于观察组(P<0.05)。结论剑突下小切口和经腋中线直切口辅助胸腔镜Nuss手术均可改善患儿心功能指标,但前者术后并发症较多,而后者手术时间较短,术中出血量较少,矫形效果较好。
Objective To compare the clinical effects of thoracoscopic Nuss minimally invasive(Nuss)surgery with different incisions on pediatric pectus excavatum.Methods A prospective randomized controlled study was conducted on 64 children with pectus excavatum admitted to the First Affiliated Hospital of Zhengzhou University from December 2019 to December 2021.According to random number table method,they were divided into control group and observation group,with 32 cases in each group.Subxiphoid small incision assisted thoracoscopic Nuss surgery was performed in the control group,and midaxillary straight incision assisted thoracoscopic Nuss surgery was performed in the observation group.The postoperative indexes,orthopedic effects,cardiac function indexes[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF)]before and 1 month after plate removal,and postoperative complications between the two groups were compared.Results The operation time of the control group was longer than that of the observation group,the intraoperative blood loss was more than that of the observation group,and the orthotic effect was worse than that of the observation group(P<0.05).The levels of LVEDD,LVEF and LVESD in two groups were higher 1 month after plate removal than those before surgery(P<0.05).The total incidence of postoperative complications in the control group was higher than that in the observation group(P<0.05).Conclusions Both the small incision under the xiphoid process and the direct incision through the midaxillary line assisted thoracoscopic Nuss surgery can improve the cardiac function indicators of children.However,the former has higher postoperative complications,while the latter has shorter surgical time,less intraoperative blood loss,and better corrective effects.
作者
赵鸽
Zhao Ge(Department of Pediatric Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,China)
出处
《临床医学》
2025年第5期1-4,共4页
Clinical Medicine
关键词
剑突下小切口
腋中线直切口
胸腔镜
漏斗胸微创矫正术
小儿漏斗胸
Small incision under the xiphoid process
Midaxillary straight incision
Thoracoscopy
Nuss minimally invasive surgery
Pediatric pectus excavatum
