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目的总结Nuss手术治疗小儿漏斗胸的经验方法 2005年5月至2008年1月复旦大学附属儿科医院心胸外科采用胸腔镜辅助下改良Nuss术治疗56例中重度漏斗胸患儿,包括复发性漏斗胸3例根据Park分型,其中对称型34例,非对称型17例,非平衡型5例。术前胸部CT测量Haller指数平均值4.79(3.1~10.0)对非对称和不平衡性漏斗胸采用个体化的钢板塑型及斜行肋间放置钢板技术结果全组病人手术顺利,术后胸部CT测量Haller指数平均值2.76(2.2~3.6)。术后平均住院5.8d。术后并发少量胸腔积液5例,气胸2例,伤口感染1例,均保守治疗痊愈。结论 Nuss手术矫治小儿漏斗胸创伤小、操作简便、并发症少,通过个体化的钢板塑型及斜行肋间放置钢板技术,适合小儿绝大多数类型漏斗胸的治疗。
OBJECTIVE: To summarize the experience of nuss operative treatment of infundibulum in children from May 2005 to January 2008, Department of Cardiothoracic Surgery, Pediatric Hospital of Fudan University. Thirty-six patients with moderate and severe funnel chest funnel were treated with thoracoscope assisted Nuss operation, including recurrent funnel chest Three cases were classified according to Park, including 34 cases of symmetry, 17 cases of asymmetry and 5 cases of non-equilibrium. Preoperative chest CT measurement Haller index average 4.79 (3.1 ~ 10.0) For asymmetric and unbalanced funnel chest using individualized steel plate and inclined intercostal plate placement technique Results All patients underwent successful operation. Postoperative chest CT The average Haller index was measured 2.76 (2.2-3.6). The average postoperative hospital stay 5.8d. Postoperative small amount of pleural effusion in 5 cases, 2 cases of pneumothorax, wound infection in 1 case, conservative treatment of healed. Conclusion Nuss operation in children with funnel chest trauma is small, easy to operate, less complications, through the individual steel plate and oblique intercostal plate placement technology, suitable for pediatric most types of funnel chest treatment.