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目的总结改良Nuss手术治疗小儿漏斗胸的经验。方法 2006年7月-2011年1月本院开展改良Nuss手术共治疗小儿漏斗胸23例。男19例,女4例;年龄2.5～17.0岁(平均8.2岁)。18例为对称性漏斗胸,5例为非对称性漏斗胸。20例在胸腔镜辅助下完成手术,3例未使用胸腔镜。结果 23例均顺利完成手术。1例出院后3个月切口感染,固定器外露,再次手术将固定器放在对侧,治疗后痊愈。1例术后疼痛,对症治疗后痊愈。1例术后出现少量气胸,经保守治疗自行吸收。术后近期效果评价:优20例,良3例。出院后随访1个月～3 a,患儿生长发育正常,外形满意,活动量如健康儿童。其中2例钢板已取出,仍保持满意效果。结论改良Nuss手术矫正漏斗胸简单、易行,微创。利用胸腔镜更安全,且近、远期效果均良好。
Objective To summarize the experience of modified Nuss surgery in pediatric funnel chest. Methods From July 2006 to January 2011, our hospital performed a total of 23 cases of pediatric funnel chest treated with modified Nuss operation. 19 males and 4 females; aged 2.5 to 17.0 years (mean, 8.2 years). 18 cases of symmetrical funnel chest, 5 cases of asymmetric funnel chest. Twenty patients underwent thoracoscopic surgery with thoracoscope assisted. Results All the 23 cases completed the operation smoothly. One case was incisional infection 3 months after discharge, and the fixator was exposed. After the operation, the fixator was placed on the contralateral side and healed after treatment. One case of postoperative pain, symptomatic treatment recovered. A small amount of pneumothorax occurred after surgery and was absorbed by conservative treatment. Short-term effect of postoperative evaluation: excellent in 20 cases, good in 3 cases. After discharge from 1 month to 3 years after follow-up, children with normal growth and development, satisfactory shape and activity such as healthy children. Two of the plates were removed and still maintain satisfactory results. Conclusion Improved Nuss operation for correction of funnel chest is simple, easy and minimally invasive. Use of thoracoscope safer, and near, long-term results are good.