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目的:探讨在Nuss手术中采用斜行放置钢板矫治大龄儿童漏斗胸的可行性和手术技巧。方法:回顾性分析西安市儿童医院普外一科自2017年6月至2018年12月收住的23例大龄漏斗胸患儿的临床资料。其中，男17例，女6例；年龄10～17岁，平均13岁。在NUSS手术中均采用斜行放置钢板，其中合并扁平胸的4例，增加一横行放置钢板，术后门诊长期随访。结果:23例患儿手术均顺利完成，手术时间为(60±15)min，术中失血量为(6±3)ml。术中出现肋间肌撕裂1例，重新选择钢板出入点。术后住院时间为(6±1)d，无钢板移位及伤口感染等并发症，效果良好。本组患儿术后均采用门诊复查随访，随访时间为10～28个月。术后双侧肋缘增高2例，给予支具下压恢复；另1例钢板一侧下压赫氏沟力量过大，引起赫氏沟轻度内陷，目前随访观察中。手术随访效果评估，优良22例(96%)，中1例(4%)。结论:大龄漏斗胸患儿采用钢板斜行放置安全有效，值得在临床推广。“,”Objective:To explore the feasibility of Nuss procedure with oblique placement for correcting pectus excavatum in elder children.Methods:From June 2017 to December 2018, 23 elder children of pectus excavatum were selected. There were 17 boys and 6 girls with a mean age of 13(10-17) years. Nuss procedure was performed for correcting pectus excavatum by oblique placement. Four cases of flat chest were implanted with an extra horizontal brace. Long-term postoperative clinic follow-ups were conducted.Results:All 23 cases were successfully completed. The mean operative duration was (60±15) min and intraoperative blood loss (6±3) ml. For one case of intraoperative intercostal muscular avulsion, the plate entry-and-exit points were re-selected. The mean postoperative hospitalization stay was (6±1) days. Bilateral costal margins increased postoperatively in 2 cases and reverted after supporting. Mild Harrison groove depression occurred due to unilateral pressure of steel plate. During a follow-up period of 10-28 months, the postoperative outcomes were excellent (n=22, 96%) and moderate (n=1, 4%).Conclusions:Oblique plating is safe and efficacious for correcting pectus excavatum in elder children during Nuss procedure.