漏斗胸微创单根板矫治胸廓成形的生物力学及影响因素

目的 探讨微创矫治漏斗胸的生物力学及影响因素。方法 24例漏斗胸患者，其中男性21例，女性3例；年龄8 ～ 27岁，平均年龄16.3岁。分型：Ⅰ型15例，Ⅱ型 9例。分成儿童组8例，青年组16例。术前测量患者胸围、身高和体质量。胸部CT扫描测量漏斗胸指数（HI）。用微创方法矫治，术中使用1根矫形板；术中用电子显示拉力计测量抬举胸骨单纯成形压力、施压成形压力和矫形板支撑压力，用专用软件分析结果。结果 单纯成形和矫形板的力学强度，24例用单根矫形板者压力，儿童组分别是（127.3 ± 44.3） N、（68.5 ± 14.8） N；青年组分别是（166.6 ± 44.1） N、（89.6 ± 23.4） N；两组前后比较，差异有显著统计学意义（P = 0.000 1）。使用单根矫形板者，儿童与青年组间，单纯成形、施压成形和矫形板压力比较，差异均有统计学意义（P = 0.048）。胸廓矫形力儿童组多与身高、体质量相关，青年组多与胸围、体质量相关。结论 微创矫治漏斗胸术中成形的力学强度与矫形板的位置、年龄、胸围、身高、体质量因素有关。

Biomechanics and influencing factors of pectus excavatum corrected by minimally-invasive thoracoplasty single plate

Objective To investigate biomechanics and influencing factors of the pectus excavatum （PE） corrected by minimallyinvasive surgery. Methods A total of 24 PE patients were enrolled, included 21 males and 3 females, who were aged 8 - 27 years old with a mean age of 16.3. Among them, included the type I 15 cases and type ]] 9 cases. They were divided into 2 groups, child group（n = 8） and juvenile group（n - 16）. The thoracic circumferences, body height, body weight and chest tomography Hailer index（HI） of patients were measured at pre-operation. The PE was corrected by minimally-invasive surgery with single strut used. The mechanics of lifting merely sternum forming, lifting and pressing forming and strut pressure were measured by electron display pull dynamometer at intra-operation. The data was analyzed by special-purpose software. Results The strain strength of lifting merely sternum forming and strut pressure in single strut used for 24 patients were （127.3±44.3） N and （68.5 ± 14.8） N in child group, （166.6 ,± 44.1） N and （89.6 ± 23.4） N in juvenile group, respectively. There was significant difference in lifting merely sternum forming and strut pressure between 2 groups（P = 0.000 1）. There was also significant difference in lifting merely sternum forming, lifting and pressing（P = 0.048）. The chest formative was associated with body height and body weight in child group, but thoracic circumference and body weight in juvenile group. Conclusion It is demonstrated that the mechanical strength and molded plated of minimally-invasive corrected for PE are associated with the factors including strut location, age, thoracic circumference, body height and body weight of patient.