漏斗胸患儿手术前后心功能测定及其意义

Assessment of Cardiac Function in Children with Pectus Excavatum Before and After Operation

目的 探讨漏斗胸患儿手术前后心脏功能的变化。 方法 用超声心动图测定４１ 例漏斗胸患儿术前、术后的心脏功能，并选择年龄、性别、身高、体重相同的正常儿童４１ 例作对照。 结果 病例组患儿术前射血分数与平均左心室周径向心缩短率与对照组相比有所降低（ Ｐ＜ ０－０１） ；术后３ 个月复查时其每搏输出量增加；长期随访（ 平均４－７年） 发现患儿术后射血分数、平均左心室周径向心缩短率与每搏输出量较术前有所上升（ Ｐ＜ ０－０１） ，而且这些指标与对照组相比差异无显著性（ Ｐ＞ ０－０５） 。 结论 漏斗胸患儿术前心脏功能有损害，术后心功能可逐步恢复正常。

Objective To evaluate the cardiac function in children with pectus excavatum (PE) before and after operative correction. Methods Forty one children with PE underwent M mode echocardiography (M ME) before and after operation and followed up for 2 8 years; meanwhile 41 healthy children matched by their age, gender, and body weight were also detected by M ME. Results Preoperatively, PE group had a significantly lower ejection fraction (EF) and mean velocity of circumference fiber shortening (MVCF) than those of the control group ( P <0 01); stroke volume (SV) and fraction shortening of the minor semixe (FS) of PE group were similar to that of the control group ( P >0 05).Only SV of PE group increased at 3 months after operation. At 4.7 years after operation, FS in PE group showed no change, but EF, MVCF and SV were significantly increased ( P <0 01), and all of those indexes reached the level of control group ( P >0 05). Conclusion The cardiac function of patients with PE was decreased before operation and it can be increased up to the normal level after operation gradually.