CAJ | 학술논문

目的应用简易的胸部X线片测量法评价漏斗胸术后胸廓改善情况,探讨Nuss手术对胸廓的影响及其程度.方法对我院2004年4月至2008年3月共449例漏斗胸行Nuss手术的患儿进行回顾性分析.根据一定的入选标准,最终人选学龄前期漏斗胸患儿共80例,分成Nuss术前和取出支架术后.通过对漏斗胸患儿放置支架术前和取出支架术后的胸部X线片上胸廓各径线的测量,比较病例组术前与取出支架术后以及病例组取出支架术后与健康同龄儿的胸廓、肋骨改变情况.结果 80例漏斗胸患儿均顺利完成Nuss手术及取出支架手术.术后随访30 ～ 36个月,术后矫形效果优良率为100％,无复发及远期并发症.漏斗胸术前与取出支架术后两组测量数据P＜0.05,差异有统计学意义;漏斗胸取出支架术后与健康同龄儿组比较第5、6、7肋变化,P＜0.001,差异有统计学意义.结论漏斗胸Nuss术后胸廓各径线较漏斗胸术前改善明显,漏斗胸取出支架术后与正常同龄儿比较发现漏斗胸支架可能对胸廓存在一定的限制作用,但远期影响是否仍存在,有待进一步随访.
목적 응용간역적흉부X선편측량법평개루두흉술후흉곽개선정황,탐토Nuss수술대흉곽적영향급기정도.방법 대아원2004년4월지2008년3월공449례루두흉행Nuss수술적환인진행회고성분석.근거일정적입선표준,최종인선학령전기루두흉환인공80례,분성Nuss술전화취출지가술후.통과대루두흉환인방치지가술전화취출지가술후적흉부X선편상흉곽각경선적측량,비교병례조술전여취출지가술후이급병례조취출지가술후여건강동령인적흉곽、륵골개변정황.결과 80례루두흉환인균순리완성Nuss수술급취출지가수술.술후수방30 ～ 36개월,술후교형효과우량솔위100％,무복발급원기병발증.루두흉술전여취출지가술후량조측량수거P＜0.05,차이유통계학의의;루두흉취출지가술후여건강동령인조비교제5、6、7륵변화,P＜0.001,차이유통계학의의.결론 루두흉Nuss술후흉곽각경선교루두흉술전개선명현,루두흉취출지가술후여정상동령인비교발현루두흉지가가능대흉곽존재일정적한제작용,단원기영향시부잉존재,유대진일보수방.
Objective To introduce a new measurement that can be used to evaluate the improvement of the chest wall after Nuss procedure.Methods From April 2004 to March 2008,449 pectus excavatum(PE) patients received Nuss procedure in Hospital,and according to the inclusion criteria,there were 80 cases enrolled our group at last,then divided the cases into two groups,one group of pre-operative of Nuss surgery,and the other group of post-bar removal.All the cases had examination of posterio-anterior chest radiographs before Nuss procedure and after Nuss bar removal.The maximal distance of the outer boundary of each rib pairs (C,from the 1 st pair to the 9th),the distance between lung apex to the costophrenic angle(H)and the distance between the two costophrenic angles (W),were measured.Results All the 80 cases completed the Nuss procedure and Nuss bar removal safely and effectively.All the patients were followed up from 30 to 36 months,and no recurrence or long-term complications occurred.The measured values of post-bar removal group showed significantly increased compare to the group of pre-Nuss procedure.The measured values (rib of 5 th,6th,7th) of post-bar removal group showed statistically significant compare to the group of normal children of the same age group.Conclusion The chest wall of post-bar removal was significantly increased compare to the cases of pre-Nuss procedure.Compare to the group of normal children of the same age group,there may be some restrictions on the thoracic by the pectus bar in the group of pectus,but whether there are still thorax limited,we need further more follow-up and measurement of chest X-ray to clear.