Nuss手术微创治疗小儿漏斗胸21例
Nuss procedure for correction of pectus excavatum: a report of 21 cases
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摘要: 目的:探讨非胸腔镜Nuss手术矫治小儿漏斗胸的效果、并发症和临床经验。方法:对21例漏斗胸患儿采用Nuss手术矫治。21例均在双侧胸壁做小切口,在非胸腔镜辅助下将塑形矫形钢板由右胸壁经胸骨后穿至左胸壁,翻转矫形板,将胸骨抬起矫正胸骨凹陷,矫形钢板单侧用固定片固定于肋骨。结果:21例均顺利完成手术,手术30~50 m in,术中平均出血量≤ 10 m l。术后平均住院6.2天;4例发生少量气胸。矫形效果17例为优,4例为良。随访1~20个月,均无不适。结论:非胸腔镜辅助下Nuss手术微创治疗漏斗胸,创伤小,近期矫形效果满意,是一种值得尝试和推广的手术方法,但远期效果有待进一步观察。Abstract: Objective: To investigate the effect of Nuss procedure with non-thoracoscope in treatment of funnel chest in children.Methods: Twenty-one children with funnel chest had Nuss operation with no assistance of thoracoscope.A small incision was made in each lateral chestwall,a steel bar was inserted under the sternum from the right thoracic cavity,and then the bar was turned over to raise the sternum to the normal position.The bar was fixed to the bilateral costal bones by using two stabilizing bars.Results: The operation was successful in all the cases.The operation time ranged from 30 to 50 min,and the average blood loss was less than 10 ml.The average hospital stay was 6.2 days,pneumothorax occurred in 4 patients after the operation.The results were excellent in 17 cases and good in 4 cases.All the patients were followed up for 1-20 months with no complaints.Conclusions: Modified Nuss procedure with no assistance of thoracoscope is easy to operate with minimal invasion and good short-term results.It is worth trying and popularizing although its long term result is yet to be observed.