Nuss与Ravitch两种术式对漏斗胸患儿免疫功能影响的对比研究

目的通过检测经Nuss手术及Ravitch手术治疗的先天性漏斗胸患儿手术前后的免疫指标，对比研究两种手术方式对漏斗胸患儿术后早期免疫功能的影响。方法回顾性分析80例漏斗胸手术，其中行Nuss手术40例（Nuss组），Ravitch手术40例（Ravitch组），2组分别于术前及术后第7天检测血清免疫球蛋白IgG、IgA、IgM含量。结果术前比较2组患儿的血清IgG、IgA、IgM含量无明显差异（P〉0．05），术后第7天检测显示Nuss组患儿血清IgG、IgA、IgM含量较Ravitch组患儿明显升高，差异有统计学意义（P〈0．05）；Nuss组中，术后7d血清IgG、IgA、IgM与术前相比均有明显升高（P〈0．05），而Ravitch组中仅IgA含量在术后7d与术前比较有明显差异（P〈0．05），IgG和IgM术后7d与术前比较，差异均无统计学意义（P〉0．05）。结论Nuss手术较Ravitch手术创伤性小，患儿术后机体免疫力恢复较早，更有利于患儿康复；免疫指标的检测可以作为评估漏斗胸患儿术后手术疗效及预后的辅助手段之一。

The comparative study of Nuss surgery and Ravitch procedure to pectus excavatum children＇ s immune functional effect

Objective To comparatively study the effects of two surgical methods on early postoperative immune function of pectus excavatum in children by detecting the immune parameters of children before and after surgery who had congenital funnel chest and treated by Nuss surgery and Ravitch procedure. Methods A retrospective analysis of ten years 80 cases of funnel chest surgery, among which Nuss surgery 40 cases, and Ravitch operation 40 cases, the serum immunoglobulins IgG, IgA, IgM levels of two groups were detected at the preoperative and 7d after surgery. Results Preoperative serum IgG, IgA, IgM of the two groups children showed no significant difference （ P 〉 0.05 ）, while the tests at 7d after surgery showed that serum IgG, IgA, IgM levels of Nuss group children significantly were higher than Ravitch group children, the difference was statistically significant （ P 〈 0. 05 ） ; Serum IgG, IgA, IgM contents of Nuss group children at 7d after surgery were significantly higher than the preoperative （ P 〈 0.05 ）, while the Ravitch group, compared with the preoperative, only IgA content at 7d after surgery has significant difference （ P 〈0.05） ,IgG and IgM contents have no statistical difference （ P 〉 0.05）. Conclusion Compared with Ravitch procedure, Nuss surgery has smaller trauma on the body, earlier recovery of immunity after surgery, and better rehabilitation of children; The detection of immune parameters can be used as one of the auxiliary means to assess the efficacy after surgery and prognosis of patients.