改良Nuss手术治疗小儿漏斗胸.docVIP

改良Nuss手术治疗小儿漏斗胸 王刚 吴春 潘征夏 李洪波 李勇刚 代江涛 （重庆医科大学附属儿童医院 心胸外科 400014） 摘要：目的 总结改良微创Nuss手术治疗小儿漏斗胸的的疗效和安全性。 方法 2006年6月至2009年3月，采用非胸腔镜微创Nuss手术治疗小儿漏斗胸120例，年龄3岁~17岁8月。轻度11例，中重度94例，极重度15例。对称型83例，非对称型34例，复发性3例。 结果120例患儿均顺利完成手术，手术时间30~60分钟，术中出血平均少于10ml，术后住院天数平均7天，无一例输血。术后并发症4例气胸，2例左下肺不张，3例右肺中下叶不张并少许积液，皮下积液积气3例，钢板移位2例。116例优，4例良好。全部病例获随访，随访时间1月~33月，矫形效果好，活动量正常，其中一例术后25月取出钢板，矫形效果保持优良。结论 改良微创Nuss手术（非胸腔镜）治疗小儿漏斗胸简单，易行，安全，效果好。 关键词：Nuss手术，漏斗胸，儿童 中国法分类号：R655.1；R687.32；R726 Modified Nuss Procedure for Pectus Excavatum on Pediatric Patients WANG Gang,WU Chun,PAN Zheng-xia, LI Hong-bo, Li Yong-gang. Department of Thoracic and Cardiovascular Surgery，Chongqing University of Abstract：0bjectiv To access the efficacy and safety of the modified Nuss procedure for reparing pectus excavatum in children. Methods The data of 120 pectus excavatum patients who received the modified Nuss procedure without thoracoscope from June 2006 to March 2009, the age ranged from 3 to 17.8 years.11 cases were light,94 middle-severity and 15 very-severity.83 patients were symmetric pectus excavatum, 34 patients were asymmetric pectus excavatum,3 patients were palindromia pectus excavatum. Results The procedure was successfully completed in all 120 cases.The operating time was 30~60 min. The average bleeding in operation was less than 10 ml. The average hospital day of post-operative was 7 days. None accepted blood-transfusion.The complication of post-operative included aeropleura in 4 cases, 2 bottom left pulmonary closure, 3 pulmones dexter meta- lower lobe pulmonary closure and bit fluidify. 3 subcutaneous emphysema and fluid, 2 bar dislocation. 116 cases were excellent and 4 case wae good. All patients were followed up 1 to 33 months,the orthopedic effect were excellent, the activity ability were normal, The bar had been removed in 1 patient 25 months after surgery who still kept in excellent results.Conclusion The modified Nuss procedure (without thoracoscope) for reparing pectus excavatum in children is simp