微创NUSS手术治疗鸡胸

目的总结鸡胸的微创治疗体会。方法回顾性分析2010年7月~2013年7月我们采用微创反NUSS技术治疗32例鸡胸患者的临床资料：男26例，女6例；年龄11.8±6.7岁。鸡胸指数（HI）2.06±0.13。经胸骨前皮下隧道放置矫形钢板行胸骨沉降术，将胸骨下压，钢板两端通过固定片用钢丝固定于肋骨。结果无围术期死亡，32例均顺利完成手术，手术时间67.0±7.8 min，失血量25.0±5.2 ml，住院时间6.0±2.8 d。术后胸廓外形恢复正常，HI 2.7±0.4。胸廓外形和胸部CT影像形状满意。随访32例，随访时间1~36个月，平均随访l8个月。其中4例已取出钢板。疗效优秀27例（84.4%），良好5例（15.6%）。结论采用改进微创反NUSS技术矫治大龄鸡胸患者，是一种简单易行，安全有效的手术方式，可获得良好的近期效果。

Experience in the Treatment of Pectus Carinatum by Minim-ally Invasive Reverse Nuss Surgery

ObjectiveTo summarize the experience in minimally invasive treatment of pectus carinatum.MethodsThe clinical data of 32 pectus carinatum patients who underwent minimally invasive reverse Nuss technique in our hospital from July 2010 to July 2013 was retrospectively analyzed, with 26 males and 6 females aging (11.8±6.7) years. The Haller index (HI) was 2.06±0.13. The pectus carinatum was corrected by placing steel bar subcutaneously anterior to the sternum to apply pressure to the sternum, and the steel bar was fixed to the ribs through plates.ResultsAll the 32 cases received operation successfully, with no death occurring in the perioperative period. Operation time was (67.0±7.8) min, blood loss was (25.0±5.2) ml, and hospital stay was (6.0±2.8) d. The thoracic appearance returned to normal after operation and the HI was 2.7±0.4. The thoracic appearance and chest CT image were satisfying. Follow-up investigation of the 32 cases was performed for 1-36 months, 18 months on average. The steer bar was removed in 4 cases. Excellent effect was observed in 27 cases (84.4%) and good effect was observed in 5 cases (15.6%).ConclusionModified minimally invasive reverse Nuss technique is a simple, safe and effective surgical method to correct the pectus carinatum of older patients, which has good recent effect.