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目的探讨非胸腔镜辅助改良Nuss手术矫治漏斗胸的疗效和经验。方法回顾分析2009年1月至2013年12月采用非胸腔镜辅助改良Nuss手术矫治的47例漏斗胸患者的临床资料,根据术后6个月CT测量Haller指数及Nuss手术评定标准评价手术效果。结果全组手术顺利,手术时间为(51±20)min,术后6个月CT测量Haller指数(2.46±1.21)与术前Haller指数(4.46±1.33)相比,差异有统计学意义(P<0.01)。矫形效果:优32例,良13例,中2例,差0例,优良率95.7%。围术期发生并发症5例(10.6%),包括气胸(胸腔积气<30%)4例,少量胸腔积血1例,右侧切口感染1例,经处理或不处理自行吸收;随访6~32个月,均未发现固定片脱落、钢板移位、钢板排异等并发症。结论非胸腔镜辅助改良Nuss手术矫治漏斗胸操作简便,并发症少,可以达到良好的矫治效果。
Objective To investigate the efficacy and experience of non-thoracoscopic assisted Nuss surgery in the treatment of funnel chest. Methods The clinical data of 47 patients with funnel chest treated with non-thoracoscopic assisted Nuss surgery from January 2009 to December 2013 were retrospectively analyzed. The effect of surgery was evaluated according to the Haller index and Nuss criteria of 6-month postoperative CT. Results The operation time was 51 ± 20 minutes and the Haller index (2.46 ± 1.21) and Haller index (4.46 ± 1.33) at 6 months postoperatively were significantly different (P <0.01). Orthopedic effect: Excellent in 32 cases, good in 13 cases, fair in 2 cases, poor in 0 cases, excellent and good rate was 95.7%. Perioperative complications occurred in 5 cases (10.6%), including pneumothorax (pleural <30%) in 4 cases, a small amount of pleural hemorrhage in 1 case, right incision infection in 1 case, with or without treatment of their own absorption; ~ 32 months, did not find the fixed piece off, plate displacement, plate rejection and other complications. Conclusion Non thoracoscopic assisted Nuss operation is a simple and convenient operation for the treatment of funnel chest. It has fewer complications and can achieve good correction effect.