胸腔镜下微创漏斗胸矫形术(Nuss手术)治疗先天性漏斗胸.pdfVIP

胸腔镜下微创漏斗胸矫形术(Nuss手术)治疗先天性漏斗胸 研究生：刘斌 导师：涂远荣 教授 摘 要 目的：探讨胸腔镜辅助下Nuss 手术治疗先天性漏斗胸的疗效和安全性。 方法：2005 年7 月至2013 年4 月，对131 例年龄3-21 岁（平均13.6 岁）先天 性漏斗胸（对称型73 例，非对称型58 例）患者实施胸腔镜辅助下Nuss 手术治 疗。 结果：131 例患者均顺利完成手术，无死亡、大出血及胸腔脏器损伤等危险并发 症发生。术中出血量3-22ml，平均8.5ml；手术时间40-89min，平均53min；术 后住院天数4-9d，平均6.5d。术后并发症包括8 例气胸、3 例胸腔积液、2 例皮 下气肿、2 例钢板移位、1 例钢板过敏反应。本组中所有患者计划于术后2 年拆 除钢板，目前已有88 例患者按计划于术后2 年顺利拆除钢板，其中74 例恢复至 正常胸部解剖，12 例存在轻微的胸部凹陷，2 例手术效果一般，优良率为97.7％。 结论：胸腔镜辅助下Nuss 手术治疗先天性漏斗胸具有创伤小、出血少、不切骨、 恢复快、效果满意，方法安全可靠等优点，可广泛应用于漏斗胸的治疗。 [关键词]：漏斗胸；胸腔镜；微创漏斗胸矫形术；Nuss 手术 3 Thoracoscopy assisted minimally invasive surgery (Nuss procedure) for pectus excavatum Abstract Objective: To assess the efficacy and safety of the correction of pectus excavatum with thoracoscopy assisted minimally invasive surgery(Nuss procedure). Methods: Thoracoscopy assisted Nuss procedure were applied to 131 cases of patients with pectus excavatum from July 2005 to April 2013.The patients ranged in age from 3 to 21 (mean 13.6) years.Of the 131,73 had symmetric and 58 had asymmetric pectus excavatum. Results: The operation in all the 131 patients were performed successfully without complications of death, massive hemorrhage and intrathoracic organ injury. The bleeding volume during procedure was 3-22 ml, with an average of 8.5 ml.The time of operation was 40-89 minutes (mean 53 minutes). The time of postoperative hospital-stay was 4-9 days,with an average of 6.5 days.Early and late postoperative complications included pneumothorax in 8 patients,pleural effusion in 3 patients,subcutaneous emphysema in 2 patients,bar displacement in 2 patients,ba