Nuss法用于矫正未成年及成年漏斗胸患者的临床效果比较

目的应用Nuss法比较成年人与未成年人漏斗胸矫正的临床疗效。方法收集我科2008年1月—2010年12月收治漏斗胸患者156例,以18岁为界分为成年组(≥18岁)、未成年组(<18岁)。进行手术创伤、并发症、术后效果的比较.。结果一般情况比较:(1)平均手术时间:未成年组(62.4±5.25)min,成年组(90.6±10.23)min;术中平均出血量:未成年组(3.5±0.72)ml,成年组(12.27±5.39)ml,两组差异有统计学意义(P<0.05);(2)术后卧床时间:未成年组(2.5±0.5)d,成年组(3.35±1.2)d;平均住院日:未成年组(8.5±1.5)d,成年组(8.9±3.2)d,两组差异无统计学意义。并发症情况:未成年组出现2例术后气胸,1例术后排异反应;成年组并发症依次为胸腔积液(5例)、气胸(3例)、支撑板移位(2例)、排异反应(1例)。矫形满意度:未成年组术后外形满意率为93%,成年组为86%。结论成人Nuss手术较未成年人的难度、风险均明显增大,术后矫形效果不及未成年人。

Comparison of clinical effects of Nuss surgery on adolescent and adult patients of pectus excavatum

Objective To compare clinical effects of Nuss surgery on adolescent and adult patients of pectus excavatum(PE). Methods One hundred and fifty six cases of PE enrolled in our department from January 2008 to December 2010 were divided into two groups(adolescent group and adult group) based on whether patient is ≥18 years old.Then the operation trauma,complications and orthopedic outcome after surgery were compared. Results General conditions comparison:(1) average time during surgery:(62.4±5.25)min for adolescent group,(90.6±10.23)min for adult group;(2) average blood loss during surgery:(3.5±0.72)ml for adolescent group,(12.27±5.39)ml for adult group,the difference showed no statistical significance;(3) average time of stay-in-bed after surgery:(2.5±0.5)d for adolescent group,(3.35±1.2)d for adult group;(4) average time in hospital:(8.5±1.5)d for adolescent group,(8.9±3.2)d for adult group,the difference showed no statistical significance.Complications: adolescent group: 2 case of pneumothorax,1 case of rejection reaction;adult group: 5 cases of pleural effusion,3 cases of pneumothorax,2 cases of bar displacement and 1 case of rejection.Degree of orthopaedic satisfaction: 93% of adolescent patients are satisfied with cosmetic effect,while the figure for adult group is 86%. Conclusion Nuss surgery for adult PE patient is more difficult and dangerous than for adolescent.The orthopaedic effect is less satisfactory for adult than adolescent.