Nuss手术矫治复杂漏斗胸95例

目的 总结Nuss手术矫治复杂漏斗胸的经验和方法.方法 2006年8月至2011年7月施行漏斗胸Nuss手术443例,其中Haller指数＞6的极重度漏斗胸、严重不对称漏斗胸、有合并症的漏斗胸、复发性漏斗胸以及需放置多根钢板方能矫形满意者纳入复杂漏斗胸范畴,共95例,依漏斗胸复杂性的不同,分别和综合采用多种改良的Nuss手术技术:多钢板、斜行钢板、双弧形钢板等个性化技术；改进钢丝固定方式；合用截骨术；辅助小切口；不同侧置入胸腔镜；合并症的分期或同期手术等.结果 95例均顺利完成手术,手术(90.13 ±39.12) min,失血量(45.41±19.23) ml,无严重术中并发症,术后并发症13.6％.术后平均住院(7.21±2.87)天,效果良好,优良率92.6％.结论 对复杂的漏斗胸采用改良的Nuss手术,综合运用多种技术能取得较满意的矫形效果.

The Nuss procedure for complicated pectus excavatum

Objective To summarize the experiences of Nuss procedure for complicated pectus excavatum.Methods From August 2006 to July 2011,443 patients with pectus excavatum received Nuss operation.Among them,95 patients with complicated pectus excavatum (CT Haller index ＞ 6) received modified technique of Nuss procedure,including multi-bar technique,oblique placed bar,double arc bar technique; fix with wire ; osteotomies ; auxiliary small incision; thoracoscopy placed by different lateral.Results All operations were successfully accomplished without severe complications.The mean operative time was (90.13 ± 39.12 ) minutes and the mean volume of blood loss was (45.41 ± 19.23 )ml.The mean hospital stay was (7.21 ± 2.87 ) days.All patients have been satisfied with their surgical correction.Therapeutic results evaluation was "excellent" in 75.8％ of patients,"good" in 16.8％.Conclusion Multi modified technique of Nuss procedure can lead to a satisfactory outcome for complicated pectus excavatum patients.