| 摘要: |
| ［摘要］ 目的 探讨改良Nuss钢板不同固定方式在非胸腔镜辅助漏斗胸手术中的应用效果。方法 回顾性分析2021年7月至2023年12月在中南大学湘雅医院胸外科采用改良Nuss钢板行漏斗胸手术的53例患者的临床资料。根据是否使用钢丝固定及固定方式将患者分为无钢丝固定组（11例）、单侧固定组（15例）和双侧固定组（21例），排除5例置入2根钢板的患者和1例使用钢丝桥的患者。分析患者的总体情况并比较三组临床资料。结果 53例患者中，男45例，女8例，中位年龄15岁，中位漏斗胸指数3.86。11例（20.75%）患者未采用钢丝固定，15例（28.30%）采用单侧钢丝固定，27例（50.94%）采用双侧钢丝固定。中位随访时间17个月，51例随访满1年，15例随访满2年。术后并发症发生率为28.30%，术后1个月、1年和2年患者对矫形效果的满意人数占比分别为92.45%、90.20%和80.00%。三组术前漏斗胸指数、手术时间比较差异有统计学意义（P<0.05），且无钢丝固定组手术时间显著短于双侧固定组（P<0.05）。三组术后1个月漏斗胸指数、术后1年漏斗胸指数、术后疼痛评分、术后住院时间、术后并发症及术后1年患者对矫形效果的满意人数占比比较差异无统计学意义（P>0.05）。结论 改良Nuss钢板具有一定的矫形效果，无钢丝固定的方式在非胸腔镜辅助漏斗胸手术中是潜在可行的。 |
| 关键词: 漏斗胸 改良Nuss手术 Nuss钢板 固定方式 |
| DOI：10.3969/j.issn.1674-3806.2026.01.12 |
| 分类号:R 655.1 |
| 基金项目: |
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| Exploration on application effect of different methods of modified Nuss bar fixation for non-thoracoscopic-assisted pectus excavatum surgery |
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AI Yan, LI Linfeng, LI Xizhe, WANG Sicong, YANG Yuqi, CHENG Yuanda
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Department of Thoracic Surgery, Xiangya Hospital of Central South University, Changsha 410008, China
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| Abstract: |
| ［Abstract］ Objective To explore the application effect of different methods of modified Nuss bar fixation for non-thoracoscopic-assisted pectus excavatum(PE) surgery. Methods A retrospective analysis was conducted on the clinical data of 53 patients who underwent PE surgery by using modified Nuss bar in Department of Thoracic Surgery, Xiangya Hospital of Central South University from July 2021 to December 2023. According to whether or not steel wire fixation was used and the fixation methods, the patients were divided into non-steel wire fixation group(11 patients), unilateral fixation group(15 patients), and bilateral fixation group(21 patients), excluding 5 patients with 2 steel bars fixed and 1 patient with steel wire bridge. The overall condition of the patients was analyzed and the clinical data were compared among the three groups. Results Among the 53 patients, 45 patients were male and 8 patients were female, with a median age of 15 years and a median Haller index of 3.86. Steel wire fixation was not used in 11 patients(20.75%), and unilateral steel wire fixation was used in 15 patients(28.30%), and bilateral steel wire fixation in 27 patients(50.94%). The median follow-up time was 17 months. Fifty-one patients had a follow-up period of 1 year, and 15 patients had a follow-up period of 2 years. The incidence of postoperative complications was 28.30%, and the proportions of the patients who were satisfied with the orthopedic treatment outcomes at 1 month, 1 year and 2 years after surgery were 92.45%, 90.20% and 80.00%, respectively. There were statistically significant differences in the preoperative Haller index and operation duration among the three groups(P<0.05), and the operation duration of the non-steel wire fixation group was significantly shorter than that of the bilateral fixation group(P<0.05). There were no statistically significant differences in the postoperative pain scores, Haller indexes at 1 month and 1 year after surgery, length of hospital stay after surgery, postoperative complications and the proportion of the patients who were satisfied with the orthopedic treatment outcomes at 1 year after surgery among the three groups(P>0.05). Conclusion The modified Nuss bar fixation has a certain orthopedic effect. The non-wire fixation method is potentially feasible for non-thoracoscopic-assisted PE surgery. |
| Key words: Pectus excavatum(PE) Modified Nuss procedure Nuss bar Fixation methods |
