【摘要】 目的探讨Nuss手术治疗漏斗胸的安全性及其近期疗效。方法采用Nuss手术矫治漏斗胸6例,均在胸腔镜直视下将矫形钢板经过胸骨凹陷最低点将凹陷的胸骨撑起,使胸骨和前胸壁凸起恢复正常的形状。结果6例均顺利完成手术,无中转开放手术者。平均手术时间48(40~55)min,出血量平均10(5~20)ml。无血(气)胸、皮下气肿、切口感染、心包或心脏损伤等手术并发症。术后平均住院5(4~7)d。均获随访,平均12.3(6~18)个月,优5例,良1例。胸廓外观维持良好,未见矫形板旋转、移位或固定器滑脱等。结论Nuss手术矫治小儿漏斗胸安全有效,具有微创、塑型美观等优点;近期效果满意,远期效果还需进一步观察。更多还原

【Abstract】 Objective To evaluate the safety and short-term effect of the minimally invasive Nuss procedure for correcting the pectus excavatum.Methods 6 severe pectus excavatum cases with Haller index more than 3.2,whose age ranged from 6 to 19 years,were treated by Nuss procedure.During the operation,a convex steel bar was inserted to the rear of sternum through small bilateral thoracic incisions under the video-assisted thoracic surgery.Results No one conversed to open surgery.The mean operating duration was 48 minutes(range,40～55 minutes),and the mean blood loss was 10 ml(range,5～20 ml).No intraoperative or postoperative complication was found,such as haematothorax or pneumothorax,incision infection,pneumonia,and mediastinal injury.The average hospital stay was 5 days(range,4～7 days).With 6 to 18 months(average,12.3 months) follow-up,the outcome revealed excellent in 5 cases and good in 1 case.The thoracic appearance retained satisfactory shape without displacement of the implant.Conclusions The short-term effect of Nuss procedure is encouraging due to the qualities as minimal invasion,low morbidity,short hospital stay,satisfactory reshaping result,and considerable improvement in physiologic and psychological function.Therefore,the Nuss technique is safe and effective for correcting pectus excavatum in children.Nevertheless,the long-term effect remains to be further researched.更多还原