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目的探讨Nuss手术矫治漏斗胸单侧应用固定片的疗效与安全性。方法收集南京医科大学第一附属医院胸外科2012年1月至2014年12月期间收治的先天性漏斗胸患者62例,其中26例采取双侧应用固定片的Nuss手术,36例采取单侧应用固定片的Nuss手术。回顾性分析两组患者性别、年龄、Nuss手术时间、术中出血量、术后住院时间、手术并发症、住院总费用、取内固定装置手术时间及疗效评价。结果 62例均顺利完成Nuss手术,单侧应用固定片的Nuss手术组较双侧应用固定片的Nuss手术组患者住院总费用下降[(36 489.4±1 711.3)元vs(41 430.2±1 940.9)元,P<0.01]、术后并发症(钢板排异致切口不愈合)发生率降低[1.4%(1/72)vs 13.5%(7/52),P<0.05];患者性别、年龄、Nuss手术时间、术中出血量、术后住院时间、畸形矫治效果及取内固定装置手术时间两组间差异无统计学意义(P均>0.05);两组均无围手术期死亡病例。结论单侧应用固定片Nuss手术矫治漏斗胸安全、有效,可简化手术过程、降低患者医疗费用、降低术后并发症。
Objective To investigate the curative effect and safety of Nuss operation on unilateral fixation of funnel chest. Methods Sixty-two patients with congenital funnel chest admitted to Department of Thoracic Surgery, the First Affiliated Hospital of Nanjing Medical University from January 2012 to December 2014 were recruited. Among them, 26 cases were treated with double-sided Nuss fixation and 36 cases were unilateral Nuss surgery to fix the piece. Retrospective analysis of two groups of patients gender, age, Nuss operation time, intraoperative blood loss, postoperative hospital stay, surgical complications, hospitalization costs, internal fixation device operation time and efficacy evaluation. Results All 62 patients underwent Nuss operation successfully. The total cost of Nuss operation in the Nuss operation group was significantly lower than that in the Nuss operation group [(36 489.4 ± 1711.3) vs 41 430.2 ± 1440.9] (P <0.01), and the incidence of postoperative complications (incision nonunion after plate excision) was significantly lower (1.4% (1/72) vs 13.5% (7/52), P <0.05] Nuss operation time, intraoperative blood loss, postoperative hospital stay, orthodontic treatment and internal fixation device operation time had no significant difference between the two groups (P> 0.05). There were no perioperative deaths in both groups. Conclusion Nuss operation is a safe and effective method to treat the funnel chest with one-sided fixation. It can simplify the operation process, reduce the medical cost and reduce the postoperative complications.