Objective To study the application CT scans in Nuss procedure for pectus excavatum. Methods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008. The preoperative CT scan was ca...Objective To study the application CT scans in Nuss procedure for pectus excavatum. Methods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008. The preoperative CT scan was carried out for evaluation of the deformity degree and morphology classification of chest wall malformation,展开更多
Objective To investigate the indication,feasibility and technique of minimally invasive Nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence....Objective To investigate the indication,feasibility and technique of minimally invasive Nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence. Methods 31 patients including 24 boys and 7 girls,suffered from pectus excavtum were corrected by Nuss procedure under thoracoscope. The average age展开更多
Background: Adolescents with pectus excavatum (PE) are often affected by their body shape. The aim of our approach was to quantify the patients’ individual psychological distress and to create a psychological indicat...Background: Adolescents with pectus excavatum (PE) are often affected by their body shape. The aim of our approach was to quantify the patients’ individual psychological distress and to create a psychological indication for treatment. Methods: 10 adolescents (8 male, median age 16 years, interquartile range 15 - 17 yrs.) with PE were examined at our psychological department. Using standardized psychological tests, projective tests and interviews psychologists validated the patients’ individual psychological status. All patients were offered psychological therapy and correction of the deformity. In addition, the children were followed-up by a telephone questionnaire (median follow-up after starting therapy 12.8 months (5.9 - 18.0). Results: No patient had a relevant physiological limitation. The median follow-up since presentation to our psychologists was 15.0 months (9.1 - 20.6). 8 patients (5 were operated, 2 used the vacuum bell, 1 will undergo surgery) had distinct psychological limitations especially concerning the dimensions attractiveness, self-esteem and somatisation. They demonstrated increased insecurity, anxiety and denegation of their body. Since all patients were within puberty the psychological distress due to the PE has to be interpreted as disadvantageous for their further development. 7 patients completed the follow-up questionnaire and reached a median score of 80.8% (76.4% - 86.8%), which indicates a good improvement in all patients. Conclusions: We conclude that the psychological indication for treatment is justified, since our results support this indication.展开更多
目的对胸膜外入路与胸膜腔入路钢板植入胸骨抬举术(Nuss手术)治疗小儿漏斗胸的效果进行比较。方法2006年7月～2007年11月28例漏斗胸患儿按手术时间分为胸膜外入路组(n=12)和胸膜腔入路组(n=16),比较2组手术情况和疗效。结果2组均顺利完...目的对胸膜外入路与胸膜腔入路钢板植入胸骨抬举术(Nuss手术)治疗小儿漏斗胸的效果进行比较。方法2006年7月～2007年11月28例漏斗胸患儿按手术时间分为胸膜外入路组(n=12)和胸膜腔入路组(n=16),比较2组手术情况和疗效。结果2组均顺利完成手术,术中未发生气胸,无心包、心脏、肺损伤,手术结束漏斗畸形即校正。2组手术时间(34.4±3.4)min vs(33.4±5.9)min无统计学差异(t=0.524,P=0.605)。胸膜外入路组术中出血量(2.5±0.5) ml显著少于胸膜腔入路组(7.5±2.6)ml(t=-6.542,P=0.000),但最大出血量仅有10 ml。胸膜外入路组住院时间(3.8±1.2)d显著短于胸膜腔入路组(5.6±1.8)d(t=-2.994,P=0.006)。胸膜外入路组满意率为100%与胸膜腔入路组93.8%无统计学差异(P=1.000)。胸膜外入路组皮下气肿、胸膜刺激征发生率显著低于胸膜腔入路组(0 vs 31.2%,P= 0.053;0 vs 31.2%,P=0.053)。28例患儿随访2～10个月,平均7.6月,所有患儿胸廓外形维持优良,无钢板及固定器移位、滑动或旋转,无肺感染。结论胸膜外入路与胸膜腔入路钢板植入胸骨抬举术治疗小儿漏斗胸安全、可行、有效。胸膜外入路与胸膜腔入路Nuss手术比较具有并发症少、恢复快、胸膜腔完整等优点。展开更多
文摘Objective To study the application CT scans in Nuss procedure for pectus excavatum. Methods 648 children with pectus excavatum underwent Nuss procedure from July 2002 to September 2008. The preoperative CT scan was carried out for evaluation of the deformity degree and morphology classification of chest wall malformation,
文摘Objective To investigate the indication,feasibility and technique of minimally invasive Nuss procedure with thoracoscope by using double braces in the treatment of wide-scope pectus excavatum repairing in adolescence. Methods 31 patients including 24 boys and 7 girls,suffered from pectus excavtum were corrected by Nuss procedure under thoracoscope. The average age
文摘Background: Adolescents with pectus excavatum (PE) are often affected by their body shape. The aim of our approach was to quantify the patients’ individual psychological distress and to create a psychological indication for treatment. Methods: 10 adolescents (8 male, median age 16 years, interquartile range 15 - 17 yrs.) with PE were examined at our psychological department. Using standardized psychological tests, projective tests and interviews psychologists validated the patients’ individual psychological status. All patients were offered psychological therapy and correction of the deformity. In addition, the children were followed-up by a telephone questionnaire (median follow-up after starting therapy 12.8 months (5.9 - 18.0). Results: No patient had a relevant physiological limitation. The median follow-up since presentation to our psychologists was 15.0 months (9.1 - 20.6). 8 patients (5 were operated, 2 used the vacuum bell, 1 will undergo surgery) had distinct psychological limitations especially concerning the dimensions attractiveness, self-esteem and somatisation. They demonstrated increased insecurity, anxiety and denegation of their body. Since all patients were within puberty the psychological distress due to the PE has to be interpreted as disadvantageous for their further development. 7 patients completed the follow-up questionnaire and reached a median score of 80.8% (76.4% - 86.8%), which indicates a good improvement in all patients. Conclusions: We conclude that the psychological indication for treatment is justified, since our results support this indication.
文摘目的对胸膜外入路与胸膜腔入路钢板植入胸骨抬举术(Nuss手术)治疗小儿漏斗胸的效果进行比较。方法2006年7月～2007年11月28例漏斗胸患儿按手术时间分为胸膜外入路组(n=12)和胸膜腔入路组(n=16),比较2组手术情况和疗效。结果2组均顺利完成手术,术中未发生气胸,无心包、心脏、肺损伤,手术结束漏斗畸形即校正。2组手术时间(34.4±3.4)min vs(33.4±5.9)min无统计学差异(t=0.524,P=0.605)。胸膜外入路组术中出血量(2.5±0.5) ml显著少于胸膜腔入路组(7.5±2.6)ml(t=-6.542,P=0.000),但最大出血量仅有10 ml。胸膜外入路组住院时间(3.8±1.2)d显著短于胸膜腔入路组(5.6±1.8)d(t=-2.994,P=0.006)。胸膜外入路组满意率为100%与胸膜腔入路组93.8%无统计学差异(P=1.000)。胸膜外入路组皮下气肿、胸膜刺激征发生率显著低于胸膜腔入路组(0 vs 31.2%,P= 0.053;0 vs 31.2%,P=0.053)。28例患儿随访2～10个月,平均7.6月,所有患儿胸廓外形维持优良,无钢板及固定器移位、滑动或旋转,无肺感染。结论胸膜外入路与胸膜腔入路钢板植入胸骨抬举术治疗小儿漏斗胸安全、可行、有效。胸膜外入路与胸膜腔入路Nuss手术比较具有并发症少、恢复快、胸膜腔完整等优点。
