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目的总结漏斗胸并其他心胸疾病的一期手术治疗的经验。方法回顾性分析13例漏斗胸并其他心胸疾病同时行一期手术的患儿的资料,其中7例并先天性心脏病(先心)(4例并VSD,3例并ASD),4例并先天性肺囊肿,1例并膈膨升,1例并纵隔神经纤维瘤病。将患儿分为漏斗胸并先心组和漏斗胸并胸科疾病组,均采用Nuss手术纠治漏斗胸,并同期手术治疗相关疾病。同期随机选取30例单纯性先心患儿及10例单纯漏斗胸患儿作为对照组。并对手术前后的Hallar指数、手术时间、术后胸引量、术后胸管放置时间、术后机械通气时间和ICU时间等相关数据进行统计学分析。结果 13例患者均治愈出院,无严重并发症,术后Haller指数明显改善(P<0.05)。漏斗胸并先心组手术时间与单纯先心组及单纯漏斗胸组比较,其分布均有统计学差异(Pa<0.05)。漏斗胸并先心组和单纯先心组术后胸引量、术后胸管放置时间、术后机械通气时间、术后ICU时间比较差异均无统计学意义。术后心肺功能稳定,胸廓外形满意。结论一期手术治疗漏斗胸并胸部其他疾病是一种安全可行的治疗方案,避免或减少了分期手术,减轻了患者痛苦。
Objective To summarize the experience of first-stage surgical treatment of funnel chest and other chest diseases. Methods The data of 13 cases with funnel chest and other cardiopulmonary diseases underwent primary surgery were analyzed retrospectively. Among them, 7 cases had congenital heart disease (congenital heart disease) (4 with VSD, 3 with ASD) and 4 with Congenital pulmonary cysts, 1 case and diaphragmatic swelling, 1 case of mediastinal neurofibromatosis. The children were divided into funnel chest and heart group and funnel chest and thoracic disease group, were treated with Nuss funnel funnel chest, and the same period surgical treatment of diseases. During the same period, 30 cases of simple heart-shaped children and 10 cases of simple funnel-chest children were randomly selected as the control group. The Hallar index, operation time, postoperative thoracic index, postoperative chest tube placement time, postoperative mechanical ventilation time and ICU time before and after surgery were statistically analyzed. Results All the 13 patients were cured and discharged without serious complications. The Haller index of postoperative patients was significantly improved (P <0.05). Funnel chest and heart group operation time compared with simple congenital heart group and simple funnel chest group, the distribution was statistically significant (Pa <0.05). Funnel chest and heart group and simple heart group postoperative chest volume, postoperative chest tube placement time, postoperative mechanical ventilation time, postoperative ICU time difference was not statistically significant. Cardiopulmonary function after surgery, thorax shape satisfactory. Conclusions The first-stage operation for the treatment of funnel chest and other thoracic diseases is a safe and feasible treatment plan to avoid or reduce the staging operation and relieve the patient’s suffering.