胸廓畸形的整体分类法

Integral classification method of thoracic deformity

目的介绍一种胸廓畸形的整体分类方法。方法对2015年3月至2017年3月我院869例胸廓畸形患者进行观察,先按传统分类方法进行统计,然后用整体分类法对所有患者进行分类。分类方法为:以正常前胸壁平面为标准,将胸廓畸形先分为Ⅰ型和Ⅱ型:低于该平面者为Ⅰ型,高于该平面者为Ⅱ型。再根据畸形具体特征将其分为Ⅰ-a、Ⅰ-b、Ⅰ-c、Ⅰ-d、Ⅰ-e、Ⅰ-f、Ⅰ-g和Ⅱ-a、Ⅱ-b、Ⅱ-c、Ⅱ-d等亚型。结果纳入分类体系的总例数为840例,占全部患者的96.7%,其余29例(3.3%)为复杂畸形,使用单一分类名称无法准确描述。与传统分类方法相比较,漏斗胸和鸡胸患者被分成不同亚群,Poland综合征分型不复存在,鸽子胸则单独成为Ⅱ-c型。结论整体分类法是一种简单实用的分类方法,由于该方法直接以畸形与手术相关的特征进行分类,因此对手术的实施具有良好的指导作用,但其优越性尚有待于进一步证实。

Objective To introduce an integral classification method of thoracic deformity. Methods From March 2015 to March 2017, 869 patients with thoracic deformity were observed. The patients were classified according to the traditional classification method at first, and then were classified according to the integral classification method.According to the standard plane of the normal chest wall, the chest deformities were classified into types Ⅰ and Ⅱ：those below the plane belonged to type Ⅰ, and those above the plane belonged to type Ⅱ. Then two types were divided into subtypes Ⅰ-a, Ⅰ-b, Ⅰ-c, Ⅰ-d, Ⅰ-e, Ⅰ-f, Ⅰ-g and Ⅱ-a, Ⅱ-b, Ⅱ-c, Ⅱ-d according to the specific characteristics of malformation. Results There were 840 patients included in the classification system, accounting for 96.7% of the total patients, and the remaining 29（3.3%） were complicated malformations, which could not be accurately described by using a single classification type. Compared with the traditional classification methods, patients with pectus excavatum and pectus carinatum were divided into different subtypes. Poland syndrome did not exist any longer, and Dove chest alone became the type Ⅱ-c. Conclusion Integral classification method is a simple and practical classification method. Since the method directly depends on the characteristics of malformation which is related to the operation, it plays a guiding role in the operation. But its superiority needs to be further confirmed.