Nuss手术治疗小儿漏斗胸

Nuss procedure for treating pectus excavatum in children

目的:探讨Nuss手术治疗小儿漏斗胸的疗效和安全性。方法:36例均在气管插管全麻下手术。双侧胸壁做横行切口,在胸腔镜下将塑形之矫形板由右胸腔经胸骨后穿至左胸腔,翻转矫形板,将胸骨抬起矫正胸骨凹陷,矫形板两侧用固定片固定于肋骨。矫形板放置2年后取出。结果:36例均在胸腔镜辅助下顺利完成手术,手术时间35～60 min,平均50 min。术中出血量5～15 ml,平均8ml。术后气胸1例,皮下气肿3例,右侧固定片滑脱1例,矫形板轻度翻转1例。术后住院6～9 d,平均7 d。随访6～24个月,平均11个月。结论:Nuss手术具有切口小而隐蔽、手术时间短、出血少、活动早、手术创伤小、无手术瘢痕、矫形效果好等优点,手术方法安全可行,值得推广。

Okjective：To explore the effect and safety of the Nuss procedure for treating peetus exeavatum in children. Methods： All the operations were performed under general anesthesia with endotraeheal intubation.A transverse incision was made in each lateral chest wall.A steel bar was passed under the sternum from the right thoracic cavity under thoraeoseope.Then the bar was turned over to raise the sternum to the normal position.The bar was fixed with bilateral costal bones by using two stabilizing bars.The bar was removed 2 years after the procedure. Results：The procedure was completed under thomeoseope smoothly in all the 36 patients.The operating time was 35--60 rain （mean, 50 min）.The intraoperadve blood loss was 5-15 ml （mean, 8 ml）.Complieations included postoperative pneumotlaotax in 1 patient,subcutaneous emphysema in 3 patients,bar displacement in 1 patient,and lateral stabilizer dislocation in 1 patient.The length of postoperative hospital stay was 6-9 d（mean,7 d）. The duration of follow-up was 6-20 months（mean, 11 months）. Conclusion： The Nuss procedure has many advantages such as small and masked incision,short operation time, little＇blood loss,quick recovery ,little trauma.It is a safy and reliable procedure.