【摘要】 目的探讨微创胸骨沉降术治疗鸡胸的可行性。方法 2009年8月~2016年9月我院应用微创胸骨沉降术治疗鸡胸59例,其中单纯胸骨体前凸型鸡胸38例行微创胸骨沉降术,选取两侧腋中线做切口,经前胸壁最高点皮下置入矫形钢板,将突起的胸骨下压至胸廓平坦理想高度;21例复杂型鸡胸采取个体化手术方案:微创胸骨沉降术+Nuss手术矫正19例,胸骨横行截骨+微创Nuss术1例,微创胸骨沉降术+神经纤维瘤切除术1例。结果 59例均顺利完成手术,无围手术期并发症。38例微创胸骨沉降术手术时间(125±20)min,出血量(12.5±2.4)ml;19例微创胸骨沉降术+Nuss手术矫正手术时间(192±47)min,出血量(19.3±4.1)ml;1例胸骨横行截骨+微创Nuss术手术时间170 min,出血量20 ml;1例微创胸骨沉降术+神经纤维瘤切除术手术时间150 min,出血量35 ml。术后按照钢板置入术后1、4、12、24个月进行随访,28例取出钢板的时间为(22.9±5.9)月,随访至取出钢板术后1年,矫形效果满意。结论微创胸骨沉降术治疗鸡胸安全可行。对于复杂型鸡胸需采取改良的个体化手术方式,以达到满意的效果。更多还原

【Abstract】 Objective To explore the practical feasibility of minimally invasive sterna sedimentation for the correction of pectus carinatum. Methods From August 2009 to September 2016,we applied minimally invasive sterna sedimentation for the correction of 59 cases of pectus carinatum. For 38 cases of common type,we chose axillary as incision from both sides of the chest wall,then set in orthopedic plat subcutaneously from the highest point,which allowed the sternum chest drop down to the ideal height.For the other 21 cases of complex type of pectus carinatum,we applied personal therapeutics: 19 cases of minimally invasive sterna sedimentation plus Nuss procedure,1 case of sterna osteotomy combined with minimally invasive Nuss procedure,and 1 case of minimally invasive sterna sedimentation plus neurofibromatosis resection. Results All the operations were successfully completed,without perioperative complications. In 38 cases undergoing minimally invasive sterna sedimentation,the average operation time was( 125 ± 20) min and the amount of bleeding was( 12. 5 ± 2. 4) ml. In 19 cases of minimally invasive sternal settlement correction plus Nuss procedure,the average operation time was( 192 ± 47) min and the amount of bleeding was( 19. 3 ± 4. 1) ml. For one case of sternal osteotomy combined with minimally invasive Nuss procedure,the operation time was 170 min and the amount of bleeding was 20 ml. For one case of minimally invasive sternal sedimentation plus neurofibromatosis resection,the operation time was 150 min and the amount of bleeding was 35 ml. All patients were followed up at 1,4,12,and 24 months after plate placement. The time of removing the plate was( 22. 9 ± 5. 9) months in 28 patients. The orthopaedic effect was satisfactory at 1 year after the removal of the plate.Conclusions Minimally invasive sterna sedimentation for the correction of the pectus carinatum is safe and feasible. For complex type of pectus carinatum,individualized operation should be considered in order to achieve satisfactory results.更多还原