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目的总结单孔矫形术治疗漏斗胸的手术方法,临床经验,安全性及有效性。方法回顾性分析2010年11月至2015年11月我科经右胸壁约2cm切口行漏斗胸矫形术203例患者的临床资料,男164例、女39例,年龄2~19(5.7±3.0)岁,其中12岁及以下患儿188例,12岁以上15例,根据Park分型,对称型176例,非对称型27例。结果全组手术顺利,手术时间4~65(16.1±5.2)min,术后住院时间4~14(6.4±1.3)d。全组均为右侧单切口,植入1根矫形板。术后平均随访27.6(1~56)个月,无矫形板翻转、移位、胸骨再次凹陷等并发症发生。84例患者已行二期矫形板取出术,无1例漏斗胸复发。结论漏斗胸单孔矫形术在手术时间及手术创伤方面均优于Nuss手术,并且在安全性和效果方面不亚于Nuss手术,尤其适用于12岁以下小儿漏斗胸的矫治。
Objective To summarize the surgical method, clinical experience, safety and effectiveness of single hole orthopedic surgery in the treatment of funnel chest. Methods The clinical data of 203 patients undergoing funnel chest orthopedic surgery in our department from November 2010 to November 2015 were retrospectively analyzed. There were 164 males and 39 females, ranging in age from 2 to 19 (5.7 ± 3.0) Year-old, including 188 children aged 12 years and below, 15 cases over the age of 12, according to Park typing, symmetrical 176 cases, 27 cases of asymmetric. Results All patients underwent surgery successfully. The operative time was 4 to 65 (16.1 ± 5.2) min and the postoperative length of stay was 4 to 14 (6.4 ± 1.3) d. The whole group is the right single incision, implanted an orthopedic plate. After an average follow-up of 27.6 (1 ~ 56) months, no orthopedic plate turnover, displacement, sterno-concave depression and other complications occurred. Eighty-four patients underwent second-stage orthopedic plate removal without any recurrent funnel chest. Conclusion Funnel chest single hole orthopedic surgery is superior to Nuss surgery in terms of operation time and surgical trauma, and is as good as Nuss surgery in safety and efficacy, especially for correction of funnel chest in children under 12 years of age.