Background Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents' psychological and behavior. This study aimed to investigate the psychological characteristics and factors that a...Background Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents' psychological and behavior. This study aimed to investigate the psychological characteristics and factors that affect adolescents with funnel chest and to evaluate the relationship between the patients' age and their physiological and psychological health. We aimed to establish an age model for maximum surgery benefits for funnel chest patients to provide an objective basis for choosing surgery. Methods The study adopted a general evaluation approach to assess the risk and benefits of minimally invasive surgery for funnel chest. The funnel chest index, the Symptom Checklist-90, and the Eysenck Personality Questionnaire were used as assessment tools to observe physiological and psychological features in funnel chest patients. A sample of 234 adolescents with funnel chest was selected from a third-grade class-A hospital in Beijing. Age groups were adopted as an independent variable, and other factors in funnel chest patients were dependent variables. Results There was a significant difference in the relapse rate for funnel chest in the different age groups (X2=11.883, P=-O.008). There was a higher relapse rate in patients of 〈10 or 〉-19 years old than in patients of 11-18 years old. There was a significant difference in the SCL-90 total score in the different age groups (F=12.538, P=-0.0001), the patients older than 13 years had a higher score than those younger than 13 years in the SCL-90. There was a significant difference in the standard score of E (introversion/extraversion) in the different age groups (F=10.06, P=0.0001). There was also a significance in the funnel chest index before surgery in the different psychological scales (P〈0.01), with a higher funnel chest index score associated with more obvious psychological trauma. Age and the number of variables, including the relapse rate, SCL-90 score, standard score of E, and standard score of N in the EPQ were significantly correlated (correlation indices were 0.402, 0.623, -0.505, and 0.473, respectively, P〈0.01). Conclusions There are higher complication rates after surgery and relapse rates when funne{ chest patients are too young or too old. There is more obvious psychological trauma in patients with a high funnel chest index. Our results indicate that the best age for surgery for funnel chest is 14-16 years.展开更多
目的探讨日间漏斗胸Nuss术后钢板取出术患儿围术期麻醉效果。方法选取2022—2023年首都医科大学附属北京儿童医院计划按照日间手术管理模式行漏斗胸Nuss术后钢板取出术患儿,收集患儿一般资料和临床资料,观察术中、术后患儿不良事件和恢...目的探讨日间漏斗胸Nuss术后钢板取出术患儿围术期麻醉效果。方法选取2022—2023年首都医科大学附属北京儿童医院计划按照日间手术管理模式行漏斗胸Nuss术后钢板取出术患儿,收集患儿一般资料和临床资料,观察术中、术后患儿不良事件和恢复情况。结果共纳入377例患儿,其中男286例、女91例;年龄6~18岁,平均(13.0±3.6)岁,体质量(45.3±14.6)kg;美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ或Ⅱ级,均采用全身麻醉,麻醉诱导后置入气管插管33例,置入喉罩344例,术中出血量为(2.2±1.2)ml,手术时间(40.0±20.9)min,麻醉时间(56.7±22.5)min,停药至拔管时间(8.1±3.0)min,麻醉恢复室停留时间(13.0±2.9)min;术中均未出现低氧血症、高血压、低血压、心动过速、心动过缓、心律失常、术中知晓等不良事件;术后均未出现苏醒延迟、呼吸抑制、低氧血症、严重咽喉部不适、中重度疼痛、恶心呕吐、气胸、伤口出血或血肿等不良事件。结论日间漏斗胸Nuss术后钢板取出术患儿的手术操作时间短、手术及麻醉相关并发症少。术前麻醉门诊完成患儿全面评估和筛选、术中配合外科医生进行肺复张操作,术后早期识别因气胸引起的低氧血症,可提高日间漏斗胸Nuss术后钢板取出术患儿的术后恢复效果。展开更多
文摘Background Funnel chest has a negative effect on adolescents and it has a strong effect on adolescents' psychological and behavior. This study aimed to investigate the psychological characteristics and factors that affect adolescents with funnel chest and to evaluate the relationship between the patients' age and their physiological and psychological health. We aimed to establish an age model for maximum surgery benefits for funnel chest patients to provide an objective basis for choosing surgery. Methods The study adopted a general evaluation approach to assess the risk and benefits of minimally invasive surgery for funnel chest. The funnel chest index, the Symptom Checklist-90, and the Eysenck Personality Questionnaire were used as assessment tools to observe physiological and psychological features in funnel chest patients. A sample of 234 adolescents with funnel chest was selected from a third-grade class-A hospital in Beijing. Age groups were adopted as an independent variable, and other factors in funnel chest patients were dependent variables. Results There was a significant difference in the relapse rate for funnel chest in the different age groups (X2=11.883, P=-O.008). There was a higher relapse rate in patients of 〈10 or 〉-19 years old than in patients of 11-18 years old. There was a significant difference in the SCL-90 total score in the different age groups (F=12.538, P=-0.0001), the patients older than 13 years had a higher score than those younger than 13 years in the SCL-90. There was a significant difference in the standard score of E (introversion/extraversion) in the different age groups (F=10.06, P=0.0001). There was also a significance in the funnel chest index before surgery in the different psychological scales (P〈0.01), with a higher funnel chest index score associated with more obvious psychological trauma. Age and the number of variables, including the relapse rate, SCL-90 score, standard score of E, and standard score of N in the EPQ were significantly correlated (correlation indices were 0.402, 0.623, -0.505, and 0.473, respectively, P〈0.01). Conclusions There are higher complication rates after surgery and relapse rates when funne{ chest patients are too young or too old. There is more obvious psychological trauma in patients with a high funnel chest index. Our results indicate that the best age for surgery for funnel chest is 14-16 years.
文摘目的探讨日间漏斗胸Nuss术后钢板取出术患儿围术期麻醉效果。方法选取2022—2023年首都医科大学附属北京儿童医院计划按照日间手术管理模式行漏斗胸Nuss术后钢板取出术患儿,收集患儿一般资料和临床资料,观察术中、术后患儿不良事件和恢复情况。结果共纳入377例患儿,其中男286例、女91例;年龄6~18岁,平均(13.0±3.6)岁,体质量(45.3±14.6)kg;美国麻醉医师协会(American Society of Anesthesiologists,ASA)分级Ⅰ或Ⅱ级,均采用全身麻醉,麻醉诱导后置入气管插管33例,置入喉罩344例,术中出血量为(2.2±1.2)ml,手术时间(40.0±20.9)min,麻醉时间(56.7±22.5)min,停药至拔管时间(8.1±3.0)min,麻醉恢复室停留时间(13.0±2.9)min;术中均未出现低氧血症、高血压、低血压、心动过速、心动过缓、心律失常、术中知晓等不良事件;术后均未出现苏醒延迟、呼吸抑制、低氧血症、严重咽喉部不适、中重度疼痛、恶心呕吐、气胸、伤口出血或血肿等不良事件。结论日间漏斗胸Nuss术后钢板取出术患儿的手术操作时间短、手术及麻醉相关并发症少。术前麻醉门诊完成患儿全面评估和筛选、术中配合外科医生进行肺复张操作,术后早期识别因气胸引起的低氧血症,可提高日间漏斗胸Nuss术后钢板取出术患儿的术后恢复效果。