摘要
目的探讨不同年龄段漏斗胸患儿手术前后胸廓扁平程度与年龄变化的关系,为临床选择恰当的手术时机提供参考依据。方法随机选取2003年7月-2005年7月本院住院的漏斗胸患儿70例。其中1～3岁25例,>3～6岁25例,>6岁20例。均行改良Ravitch术矫治,术前和术后2 a分别摄胸部标准正侧位片,测量胸廓扁平指数。手术前后分别选择一般情况与患儿相当的无胸廓畸形儿童作为术前、术后对照组,术后另选择一般情况与患儿相当的未手术漏斗胸患儿作为未手术对照组。结果不同年龄段对照组组间胸廓扁平指数比较无显著性差异(P>0.05);病例组术前与术前对照组比较有显著性差异(P<0.05);病例组术前组间比较差异显著(P<0.05),且年龄越大,胸廓扁平指数越大;各病例组术后与术后对照组比较有显著性差异(P<0.05),胸廓扁平指数未完全恢复至正常水平,但术后与未手术对照组比较有显著性差异(P<0.05),胸廓扁平指数较术前减小,且年龄越小,术后胸廓扁平指数越小。结论各年龄组漏斗胸患儿术前胸廓较健康同龄儿童扁平,且胸廓扁平程度随年龄增长而加重;术后2 a漏斗胸患儿胸廓扁平程度未能达到正常水平,但较同龄未手术患儿有明显改善,且手术年龄越小,术后改善越明显;漏斗胸应早期手术,最恰当的手术年龄为1～3岁。
Objective To investigate the relationship of chest flat degree in different age children with pectus excavatum before and after surgery, then provide the information for the ideal age of surgery. Methods Seventy cases with pectus excavatum from Jul. 2003 to Jul. 2005 （25 cases of 1 -3 years old ,25 cases of 3 -6 years old ,20 cases of older than 6 years） were selected randomly, all children were treated with modified Ravitch procedure. Chest X - ray of anterior - posterior view and lateral view were taken in all children before surgery and after 2 years following the surgery, and the chest flat index was measured. The same amount of normal children compared with the children who had the similar age, sex, height and weight were selected as the control group before and after surgery, and the other batch of non - surgery children compared with the children who had the similar age, sex, height and weight were selected as the non - surgery control group. Results The chest flat index in different age control group was not significantly different（ P 〉 0.05 ） ;and the chest flat index between the preoperative and control group was significantly different（ P 〈 0.05）. The chest flat index in different age groups before the surgery was significantly different （ P 〈 0.05 ）, and the older children, the bigger chest flat index. The chest flat index between postoperative and control group was significantly different（ P 〈 0.05 ）, and the chest flat index was not completely recovered. The chest flat index between the postoperative group and non - surgery control group was significantly different（ P 〈 0.05 ）, and the chest flat index decreased after the procedure. Furthermore, postoperative chest value was smaller in the younger children. Conclusions The children＇s thoracic cage with pectus excavatum were flatter than the normal children, furthermore, the chest flat degree exacerbated along with the age. Two years after surgery, the chest flat index wouldn＇t reach to the normal level,but had b
出处
《实用儿科临床杂志》
CAS
CSCD
北大核心
2009年第11期824-826,共3页
Journal of Applied Clinical Pediatrics
基金
重庆市科委自然科学基金项目资助(2006BB5284)
