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双支架Nuss手术治疗青少年漏斗胸 被引量:3

Nuss procedure for the correction of pectus excavatum by using double braces in adolescence
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摘要 目的探讨使用双支架治疗青少年大范围漏斗胸微创Nuss手术的适应证、可行性和手术方法及效果。方法31例中男24例,女7例;年龄14~18岁,平均(15.32±3.12)岁。根据Hallar指数均评价为中到重度,凹陷范围为4个肋间以上。选择胸腔镜辅助Nuss手术两点或者多点双支架支撑固定法手术。结果均采用双支架在胸腔镜辅助下顺利完成Nuss手术。术后住院5~10天,平均(7.48±1.95)天;随访4个月到5年。术中发生出血2例,支架滑动移位和间断疼痛2个月各1例,均治愈。结论胸腔镜辅助双支架矫正大面积、不对称漏斗胸的Nuss手术对青少年是一种安全、有效的方法。 Objective To investigate the indication, feasibility and technique of minimally invasive nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence. Methods 31 patients including 24 boys and 7 girls, suftered from pectus excavtum were corrected by nuss procedure under thoracoseope. The average age was ( 15.32 ± 3.89)years ( ranged, 14 years and 18 years). All cases were ruoderale to severe degree according to Hallar index with depression scope of 4 ribs or more. A couple of braces of two-point or multipoint fixation for thoracoscopie-assisted nuss procedure were used. Results The procedure was successfully completed under thoracoseopy in all patients. Double braces were utilized in 27 cases, double arc bars were required in 4 cases, and muhipoint fixations were in 6 patients. The postoperative hospital stay was 5 - 11 days [ average, (7.48 ±1.95) daysl. The duration of following up was one month to three years. The perioperative complications included intraoperative hemorrhage in 2 patients, bar invertion with displacement in 1, and interrupted pain for two months in 1. All patients recovered after expectant treatment. Conclusion Nuss procedure with double braces for the correction of a large area of asymmetric pectus excavatum under thoracoscopy is safe rant effective technique for adolescence.
出处 《中华胸心血管外科杂志》 CSCD 北大核心 2011年第5期291-292,共2页 Chinese Journal of Thoracic and Cardiovascular Surgery
关键词 漏斗胸 支架 青少年 NUSS手术 Peetus excavatum Stent Adolescence Nuss procedure
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  • 1曾骐,彭芸,贺延儒,张娜.Nuss手术治疗小儿漏斗胸(附60例报告)[J].中华胸心血管外科杂志,2004,20(4):223-225. 被引量:150
  • 2曾骐,张娜,范茂槐,贺延儒.Nuss手术与改良Ravitch手术的对比研究[J].中华小儿外科杂志,2005,26(8):397-400. 被引量:89
  • 3Nuss D, Kelly RE Jr, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg, 1998,33:545-552.
  • 4Scott E, Fred R, Karen W, et al. Is the grass greener? Early results of Nuss procedure. J Pediatr Surg, 2000,35:246-251.
  • 5England DM, HoChholzer L, McCarthy MJ. Localized benign and malignant fibrou tumors of the pleura. A clinicopathologic review of 223 cases. Am J Surg Pathol, 1989,13:640-658.
  • 6Andre H, Micheal WLG, Edward PT, et al. A simple technique for preventing bar displacement with the Nuss repair of pectus excavatum. J Pediatr Surg, 2001,36:1266-1268.
  • 7Klaus S, Andreas KS, Gregori D, et al. Submuscular bar, multiple pericostal bar fixation, bilateral thoracoscopy: a modified Nuss repair in adolescents. J Pediatr Surg,2002,37:1276-1280.
  • 8Daniel PC,Robert Ek,Micheal J,et al.Experience and modification update for the mionimally invasive Nuss technique for pectus excavatum repair in 303patients.J Pediatr Surg,2002,37:437-445.
  • 9Nuss D,Kelly RE Jr.Croitoru DP ,et al.A 10-year review of an minimally invasive technique for the correction of pectus excavatum.J Pediatr Surg,1998,33:545-552.
  • 10Scott E,Fred R,Karen W,et al.Is the grass greener?Early results of Nuss procedure.J Pediatr Surg,2000,35:397-400.

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