不同年龄段先天性漏斗胸手术前后胸廓扁平程度的 - 第三军医大学学报.doc

不同年龄段先天性漏斗胸手术前后胸廓扁平程度的研究 李洪波 潘征夏 吴春 王刚 李勇刚 罗小辑 杨杰先 (重庆医科大学附属儿童医院心胸外科，重庆400014) [摘要]:目的 探讨不同年龄段漏斗胸病儿术前术后胸廓扁平程度的变化以及随年龄变化的关系，为临床选择恰当的手术时机提供参考依据。方法 从我院2003年7月至2005年7月间住院病例中随机选择漏斗胸病儿70例，1~3岁25例，3-6岁25例，6岁以上20例，均行改良Ravitch术矫治，术前和术后2年分别摄胸部标准正侧位片，测量胸廓扁平指数。术前术后分别选择例数、年龄、性别、身高、体重与患儿相当的正常儿童作对照，术后另选择例数、年龄、性别、身高、体重与患儿相当的未手术患儿作对照。结果 不同年龄段正常对照组组间胸廓扁平指数比较：差异无显著性（P0.05）；病例组术前与正常对照组比较，有显著性差异（P0.05）；病例组术前组间比较，差异有显著性（P0.05），并且年龄越大，胸廓扁平指数越大；各病例组术后与正常对照组比较：统计学上有显著差异（P0.05），胸廓扁平指数未完全恢复正常水平，但术后与未手术病例组比较，差异有显著性（P0.05），胸廓扁平指数较术前有减小，且年龄越小，术后胸廓扁平指数越小。结论 （1）各年龄组漏斗胸患儿术前胸廓较正常同龄儿童扁平，并且胸廓扁平程度随年龄增长而加重。（2）术后2年漏斗胸患儿胸廓扁平程度未能达到正常水平，但较同龄未手术病儿有明显改善，且手术年龄越小，术后改善越明显。（3）根据本研究，我们认为漏斗胸应早期手术，最恰当的手术年龄为1~3岁。 [关键词] 漏斗胸；胸廓扁平指数；改良Ravitch术；儿童 The research on the pre-and postoperative chest flat degree in the different age pattients with pectus excavatum LI Hong-bo, PAN Zheng-xia, WU Chun, WANG Gang, LI Yong-gang,LUO Xiao-ji, YANG Jie-xian .Department of Thoracic and Cardiovascular Surgery, Children’s Hospital of Chongqing Medical University, Chongqing 400014, China [Abstract]： Objective To investigate the relationship of the chest flat degree in the different age patients with pectus excavatum before and after the surgery, then provide the information for the ideal age for surgery. Methods Random select 70 cases with pectus excavatum from july 2003 to july 2005(25 patients of 1-3 years old , 25 patients of 3-6 years old,20 patients of older than 6 years), all the patients were treated with modified Ravitch procedure..Chest X-ray of AP view and lateral view were taken in all the patients before surgery and after 2 years following the surgery, Measured the chest flat index.The same amount of normal children compared with the patients who has the similar age, sex, height, weight were selected as control group beforeand after the surgery, and the other batch of non-surgery children compared with the patients who has the similar age, sex, height, weight were selected as control group a-fter the surgery. The control gr