漏斗胸不同手术方式的比较-郁珲

,,,,:NussRavitch3:38,Nuss21,Ravitch9,8,3,Nuss21(10)(11):NussRavitch(P0.05),Nuss(P0.05):Nuss2,;Nuss;Ravitch;:R682:A:167423474(2009)0220127204ComparisonofdifferentprocedureofpectusexcavatumYUHui,MAHaitao,NIBin,etal.DepartmentofCardiothoracicSurgery,theFirstHospitalofSoochowUniversity,Suzhou215006,ChinaAbstractObjectiveTocomparetheeffectofNussprocedure,modifiedRavitchprocedureandsterno2turnoverprocedure.MethodsThirty2eightcasesofpectusexcavatumrepairswerefollowedup.Amongthem,21casesreceivedNussprocedures,9receivedmodifiedRavitchproceduresand8receivedsterno2turnoverprocedures.Theconditionsbefore,duringandafteroperation,thecomplicationsandeffectwerecompared.TheeffectofNussprocedureonrepairingsymmetricorasymmetricpectusexcavatumwasanalyzed.ResultsAmongthethreegroups,therewasnostatisticdifferenceinage,postoperativecomplicationsandeffect(P0.05),buttheoperativetime,bloodloss,durationofpain,theperiodofhospitalstaywerelessinNussgroup(P0.05).TheeffectofNussprocedurewasbetterinthesymmetriccases(P0.05).ConclusionNussprocedureiseasytoperformwithminimalinvasion,andtheoperativetime,bloodloss,durationofpain,thelengthofhospitalstayarelessthantheothergroups.Therefore,Nussprocedureisabetterchoiceforpectusexcavatum,espiciallysymmetricones.KeywordsPectusexcavatum;Nussprocedue;modifiedRavitchprocedure;sterno2turnoverprocedure,,87%,1/3001/400[1];,411,5%[2],[1],,,,,,Ravitch:,215006:(1981-),,,,:1998Nuss[3]Nuss,199752008938,Nuss21,Ravitch9,8,3,11.138,30,8,324,(12.86.0),0.250.41,38Nuss21,Ravitch9,8Nuss10,11721232(P0.05)1.23:(1)3;(2),2cm,CTHailer[4]3,0.2;(3),,;(4),;(5)1.31.3.1Nuss(12),90,,,,,3cm,,,,Trocar,,,,,,,,,,,180,,7,1.3.2Ravitch815cm,,,,,,,,,,,V,,,,,,,1.3.3,,,273cm,,,,,3V,,180,,1.4X,,4:,;:,20%;:20%50%;:50%1.5SPSS13.0,(Šxs)Kruskal2Wallis,Nuss,Fisher,P0.0522.1NussRavitch,(P0.05)11(Šxs)(h)(mL)(d)(d)Nuss6.881.4623.620.15.12.16.94.0Ravitch15.001.87311.0131.87.31.010.62.514.881.89326.3114.66.80.77.41.72.222(%)Nuss9.5(2/21)4.7(1/21)4.7(1/21)0Ravitch22.2(2/9)11.1(1/9)0012.5(1/8)25.0(2/8)00:3(P0.05)2.3Nuss66.7%,Ravitch77.8%,62.5%,3(P0.05)Nuss90.0%(9/10),45.5%(5/11),(P0105)3,:(1)[5];(2)[6];(3)[7],,[8210],1998NussNuss,Nuss,,Nuss21Nuss,9Ravitch,8,3(P0.05)Nuss,,,8212322Nuss,,,Nuss21Nuss,10,11,1,,2,,,,[11]Nuss,8.6%Nuss21,:(1),,,2,;(2),,,,;(3),3cm,,,;(4),,7;(5)12,,,X,,1,15%,,X,,,,,612Nuss[12]35,,,3,,,,13,,24,Nuss2,,Nuss,,2,Nuss1,,,,,,Croitoru[11]3033,,,,,,,Hernandez[13]Nuss,,,,,,[3,14],Nuss,Nuss46,,,Nuss1s,Nuss[15],,,,,,,2,,,Nuss,,,,,,,,,,,,,,3cm,[16],,,,180,921232,,Ravitch,,,,Jeune[17][18219]0.5cm,[20],JeuneRavitchNuss,Ravitch,,Nuss2,,2NussNuss1,,,1,30%,Nuss1,,,6,,,,,,3,Nuss,,,,,Nuss,,Nuss,,Nuss,,,,41Sabiston,Spencer.SurgeryoftheChest[M].:,2001:494.2GoretskyMJ,KellyRE,CroitoruD,etal.Chestwallanomalies:pectusexcavatumandpectuscarinatum[J].AdoleseMedClin,2004,15(3):4552471.3NussD,KellyREJr,CroitoruDP,etal.A102yearreviewofaminimallyinvasivetechniqueforthecorrectionofpectusexcavatum[J].PediatrSurg,1998,33(4):5452552.4,,,.Nuss[J].,2007,28(1):426.5MullardK.Observationsontheaetiologyofpectusexcavatumandotherchestdeformities,andamethodofrecordingthem[J].BritJSurg,1967,54(2):1152120.6TheerthakaraiR,El2haleesW,JavadpoorS,etal.Severepectusexcavatumassociatedwithcorpulmonaleandchronicrespiratoryaidosisinayoungwoman[J].Chest,2001,119(6):195721961.7AvelinoM,LirianoR,FujiraR,etal.Managementoflaryngomalacia:experiencewith22cases[J].RevBrasOtorhinolaryngol,2005,71(3):3302334.8MalekMH,FonkalsrudEW,CooperCB.Ventilatoryandcardiovascularresponsestoexerciseinpatientswithpectusexcavatum[J].Chest,2003,124(3):8702882.9MalekMH,BergerDE,MarelichWD,etal.Pulmonaryfunctionfollowingsurgicalrepairofpectusexcavatum:ameta2analysis[J].EurJCardiothoracSurg,2006,30(4):6372643.10MalekMH,BergerDE,HoushTJ,etal.Cardiovascularfunctionfollowingsurgicalrepairofpectusexcavatum:ameta2analysis[J].JChest,2006,130(2):5062516.11CroitoruDP,KellyREJr,GoretskyMJ,etal.ExperienceandmodificationupdatefortheminimallyinvasiveNusstechniqueforpectusexcavatumrepairin303patients[J].PediatrSurg,2002,37(3):4372445.12EngumS,RescorlaF,WestK,etal.Isthegrassgreener?EarlyresultsofNussprocedure[J].PediatrSurg,2000,35(2):2462251.13HernandezH,VarlaA,CordobaM,etal.VideothoracoscopicextrapleuralinsertionofWalterLorenzsurgicalbarforpectusexcavatum[J].ThoracCardiovascSurg,2003,126(6):208122082.14GuntherothWG,SpiersPS.Cardiacfunctionbeforeandaftersurgeryforpectusexcavatum[J].AmJCardiol,2007,99(12):176221764.15LawsonML,CashTF,AkersR,etal.Apilotstudyoftheimpactofsurgicalrepairondisease2specificqualityoflifeamongpatientswithpectusexcavatum[J].PediatrSurg,2003,38(6):9162918.16PeltomakiT,HakkinenL.Growthoftheribsatthecostochondraljunctionintherat[J].Anat,1992,181(2):2592264.17HallerJA.Severechestwallconstrictionfromgrowthretardationaftertooextensiveandtooearly(4years)pectusexcavatumrepair:Analert[J].AnnThoracSurg,1995,60(6):185721864.18RobicsekF,FokinA.Surgicalcorrectionofpectusexcavatumandcarinatum[J].CardiovascSurg,1999,40(5):7252731.19,,,.[J].,2001,19(3):2232225.20HallerJA,LoughlinGM.Cardiorespirato