鸡胸的微创外科治疗

Minimally invasive technique for the correction of pectus carinatum

目的 介绍微创治疗鸡胸的手术方法 、并发症和相关临床经验.方法 利用微创Nuss手术的原理行胸骨沉降术治疗6例鸡胸病儿,均为男性,年龄10.5～16岁,平均（13.6±1.94）岁.术前均行CT检查,测量Hailer指数.5例采用Nuss手术的钢支撑架及固定器作为同定架,1例采用国产钛同定架及专用固定器.结果 6例均顺利完成手术,无术中并发症.手术时间80～120 min,平均（104.17±15.63）min;术中出血3～10 ml,平均（5.17±2.56）ml;术后住院5～7天;随访1～11个月.1例术后3个月时同定架脱开,再次手术固定.余无并发症.结论 微创胸骨沉降术矫正鸡胸的手术方法 安全可行,并可以增加胸廓的容积.病儿手术修复的最佳时机为10～16岁.技术方法 的改进和远期效果的评价,还需进一步研究探讨.

Objective Minimally invasive technique was used in the treatment of pectus carinatum. Indication, technical details and perioperative complication are discussed in this paper. Methods From March 2008 to January 2009,6 patients with pectus carinatum underwent minimal invasive operation by using the principle of Nuss procedure in which pressure applied through a curved steel bar that was placed subcutaneously anterior to the sternum, via lateral thoracic incisions. Preoperative CT scan were performed and Hailer index was used as operative indication. Results The average age of patients was （ 13.6 ± 1.94） years （range, 10 -16 years）. They were all males. The mean operation time was （104.17 ±15.63） minutes. The average blood loss was （5.17 ±2.56） ml. The mean hospital stay was （5.67 ±0.82） days. Postoperative follow-up was 1 - 11 months. Displacement of the stablizer was the only complication that was corrected by further fixation procedure. Conclusion The minimally invasive technique for the treatment of pectus carinatum is safe and effective with minimal complications. It can be selected as an alternative techniques and the appropriate age for this procedure is 10-16 years.