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目的探讨自体力胸骨沉降术微创治疗鸡胸的手术方法、可行性及手术效果。方法回顾性分析2011年10月至2015年9月武汉同济医院采用自体力沉降法微创矫治22例鸡胸患者的临床资料,其中男19例、女3例,平均年龄6~15(12.00±2.87)岁,对称性鸡胸17例,非对称性鸡胸5例。14例患者术前行胸部CT检查,Haller指数为1.65~2.23(1.97±0.15)。所有患者均采用NUSS矫形钢板,通过自身肋骨的固定作用下压突起胸骨以矫治鸡胸。结果所有患者均顺利完成手术,平均手术时间55~120(83.73±16.62)min,平均术中失血量10~50(28.18±11.63)ml,平均术后住院时间3~6(4.23±1.17)d。术后发生伤口感染2例,轻度气胸3例,均保守治疗后痊愈;单侧液气胸1例,经胸腔闭式引流术后痊愈出院。术后随访6~48个月,矫形效果良好。无术后持续疼痛。未出现钢板翻转、移位以及固定片滑脱。其中9例患者已经取出矫形钢板,取出后胸廓外形保持良好,未出现鸡胸复发。结论自体力胸骨沉降法微创矫治鸡胸较传统微创矫治术进一步简化了手术操作,手术安全可行,矫形效果良好。
Objective To investigate the surgical methods, feasibility and surgical effects of minimally invasive self-powered sternal settlement in treatment of chicken breast. Methods The clinical data of 22 cases of chicken breast with minimally invasive treatment of Tongji Hospital in Wuhan Tongji Hospital from October 2011 to September 2015 were retrospectively analyzed. There were 19 males and 3 females with an average age of 6-15 (12.00 ± 2.87 ) Years old, 17 cases of symmetrical chicken breast, 5 cases of asymmetric chicken breast. Thoracic CT examination was performed in 14 patients. The Haller index was 1.65-2.23 (1.97 ± 0.15). All patients with NUSS orthopedic plate, through the fixed role of their ribs under the pressure raised sternum to correct the chicken breast. Results The average operation time was 55 ~ 120 (83.73 ± 16.62) min, the average blood loss was 10 ~ 50 (28.18 ± 11.63) ml, the average postoperative hospital stay was 3 ~ 6 (4.23 ± 1.17) d . Postoperative wound infection in 2 cases, 3 cases of mild pneumothorax, were cured after conservative treatment; unilateral liquid pneumothorax in 1 case, after thoracic drainage closed and discharged. Follow-up 6 to 48 months after surgery, orthopedic effect is good. No postoperative persistent pain. No plate overturning, displacement, and slippage of the anchor. Of the 9 patients, the orthopedic plate had been removed and the shape of the thorax was well maintained without the recurrence of the chicken breast. Conclusion Self-powered sternal settlement minimally invasive treatment of chicken breast minimally invasive orthodontic surgery to further simplify the operation, the operation is safe and feasible, orthopedic effect is good.