微创Nuss手术治疗小儿漏斗胸的疗效探讨

目的：探讨在胸腔镜辅助下Nuss手术治疗小儿漏斗胸的临床疗效。方法：收集2008年10月至2011年12月采用微创Nuss手术治疗小儿漏斗胸23例的病历资料，其中对称性漏斗胸19例，非对称性漏斗胸4例。结果：本组23例均顺利完成Nuss手术，畸形得到满意矫正，手术时间40～70min，手术后住院时间5～9d。术后2例出现气胸（小于10％未予特殊处理），3d后消失，1例出现轻度皮下气肿。术后随访1个月～3年，1例3个月后钢板移位而再手术，1例出院后2周出现右侧胸腔积液，经抗感染及右侧胸腔穿刺后积液消失。余患儿均无不适，2例患儿3年后取出钢板，畸形矫治满意。结论：微创Nuss手术治疗小儿漏斗胸，创伤小，恢复快，畸形矫治满意，方法安全可行。

Efficacy Study of Thoracoscopicassisted Nuss Operation in Treatment of Child Pectus Excavatum

Objective: To assess the clinical efficacy of thoracoscopicassisted Nuss operation in treatment of child pectus excavatum.Methods: 23 patients with pectus excavatum treated by thoracoscopicassisted Nuss operation were investigated during Oct.2008 and Dec.2010.Of 23 cases,19 were symmetric funnelchest and 4 were asymmetric funnelchest.Results:The Nuss operations were successfully done on 23 pectus excavatum patients with operation time range from 40 to 70 min and the period of hospitalization was 5～9 days.Pneumothorax occurred in 2 cases who were managed conservatively(below 10%) and the symptom disappeared after 3 days.One case of mild subcutaneous emphysema was given a 1 month-3 years follow-up;one case of plate dislocation was found by follow-up in 3months with re-operation;right pleural effusion occurred in another case after 2 weeks with the effusion disappearing through anti-infection and thoracentesis;the plate of 2 cases removed after 3 years.All cases were followed up in 1month-3 years after the operation.Conclusion: The thoracoscopicassisted Nuss operation in treatment of child pectus excavatum is significantly safe and efficacious,especially has the advantages of quick recovery and cosmetic results.