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1、改良Nuss手術(shù)治療小兒漏斗胸王剛吳春潘征夏李洪波李勇剛代江濤(重慶醫(yī)科大學(xué)附屈兒童醫(yī)院心胸外科400014)摘要：目的總結(jié)改良微創(chuàng)Nuss手術(shù)治療小兒漏斗胸的的療效和安全性。方法2006年6月至2009年3M，采用非胸腔鏡微創(chuàng)Nuss手術(shù)治療小兒漏斗胸120例，年齡3歲~17歲8月。輕度11例，中重度94例，極重度15例。對(duì)稱型83例，非對(duì)稱型34例，復(fù)發(fā)性3例。結(jié)果120例患兒均順利完成手術(shù)，手術(shù)時(shí)間30?60分鐘，術(shù)屮出血平均少于10ml,術(shù)后住院天數(shù)平均7天，無(wú)一例輸血。術(shù)后并發(fā)癥4例氣胸，2例左下肺不張，3例右
2、肺中下葉不張并少許積液，皮下積液積氣3例，鋼板移位2例。116例優(yōu)，4例良好。全部病例獲隨訪，隨訪時(shí)間1月~33月，矯形效果好，活動(dòng)量正常，其中一例術(shù)后25月取出鋼板，矯形效果保持優(yōu)良。結(jié)論改良微創(chuàng)Nuss手術(shù)(菲胸腔鏡)治療小兒漏斗胸簡(jiǎn)單，易行，安全，效果好。關(guān)鍵詞：Nuss手術(shù)，漏斗胸，兒童中國(guó)法分類號(hào)：R655.1；R687.32；R726ModifiedNussProcedureforPectusExcavatumonPediatricPatientsWANGGang,WUChun,PANZheng-xia,LI
3、Hong-bo,LiYong-gang.DepartmentofTlioracicandCardiovascularSurgery,ChongqingUniversityofMedicalScience,Chongqing400014,ChinaAbstract：ObjectivToaccesstheefficacyandsafetyofthemodifiedNussprocedureforreparingpectusexcavatuminchildren.MethodsThedataof120pectusexcavat
4、umpatientswhoreceivedthemodifiedNussprocedurewithoutthoracoscopefromJune2006toMarch2009,theagerangedfrom3to17.8years.11caseswerelight,94middle-severityand15very-severity.83patientsweresymmetricpectusexcavatum,34patientswereasymmetricpectusexcavatum,3patientswerep
5、alindromiapectusexcavatum?ResultsTheprocedurewassuccessfullycompletedinall120cases.Theoperatingtimewas30?60min.Theaveragebleedinginoperationwaslessthan10ml.Theaveragehospitaldayofpost-operativewas7days.Noneacceptedblood-transfusion.Thecomplicationofpost-operative
6、includedaeropleurain4cases,2bottomleftpulmonaryclosure,3pulmonesdextermeta-lowerlobepulmonaryclosureandbitfluidify.3subcutaneousemphysemaandfluid,2bardislocation.116caseswereexcellentand4casewaegood?Allpatientswerefollowedup1to33months,theorthopediceffectwereexce
7、llent,theactivityabilitywerenormal,Thebarhadbeenremovedin1patient25monthsaftersurgerywhostillkeptinexcellentresults.ConclusionThemodifiedNussprocedure(withoutthoracoscope)forreparingpectusexcavatuminchildrenissimple,easytobeperformedandsafe?Theeffectisexcellent.K
8、eywords：Nussprocedure;Pectusexcavatum;children作者簡(jiǎn)介：王剛(1973-),男，重慶人，漢族，碩士，主治醫(yī)師，從事小兒心胸外科疾病研究。電話：13500373586,E-mail:doctorwg@gmail.com通訊作者：吳春(1963-),男，重慶人,漢族,碩士,副
