NUSS手术前后漏斗胸患者肺功能变化的临床研究

Clinical observation of pulmonary function before and after NUSS procedure in patients with pectus excavatum

目的探索NUSS手术对改善漏斗胸患者肺功能的意义。方法选择2009年1月至2013年8月于我科行NUSS手术并行肺功能检查的28漏斗胸患者,患者术前、术后3月、术后1年行肺功能检测。检查项目包括残气容积(RV)、肺总量(TLC)、肺活量(VC)、最大通气量(MVV)、一秒钟用力呼气容积(FEV1)、50%肺活量最大呼气流量(MEF50)。结果 (所有数据均与术前相比),术后3月患者RV升高,无统计学意义(P>0.05),术后1年下降,有统计学意义(P<0.05)。MVV、MEF50术后3月无明显变化(P>0.05),术后1年明显提高,有统计学意义(P<0.05)。TLC、FEV1术后3月降低,有统计学意义(P<0.05),术后1年恢复到术前水平(P<0.05)。VC术后3月明显降低,有统计学意义(P<0.05)术后1年较术前升高,有统计学意义(P<0.05)。结论漏斗胸患者NUSS术后早期肺功能虽有下降,术后1年可恢复到术前水平甚至有所提高。

Objective To evaluate the importance of NUSS procedure for pulmonary function in patients with pectus excavatum. Methods The study selected 28 patients who carried out NUSS procedure and received pulmonary function tests from January 2009 to August 2013. All of them received pulmonary function tests at baseline, 3 months and 1 year after NUSS procedure. The inspection items included residual volume （RV） , total lung capacity （ TLC）, vital capacity （ VC）, maximal voluntary ventilation （ MVV ）, forced expiratory volume in the first second （ FEV~ ）, and maximal expiratory flow in 50% vital capacity （ MEFso ）. Results Comparing with baseline, RV increased 3 months after operation （ P 〉 0. 05 ） , but it reduced 1 year after operation （ P 〈 0.05 ）. MVV and MEF50 changed a litter 3 months after operation （ P 〉 0. 05 ）, but they increased 1 year after operation （ P 〈 0. 05 ）. TLC and FEVl reduced 3 months after operation （P 〈0. 05） , but they recovered 1 year after operation （P 〉0. 05）. VC reduced 3 months after operation （ P 〈 0.05）, but it increased 1 year after operation （ P 〈 0. 05 ）. Conclusion The pulmonary function of patients with pectus excavatum declines early after NUSS procedure, but it can recover to normal or even turn better 1 year after NUSS procedure.