【摘要】：目的探討新設(shè)計(jì)的指觸引導(dǎo)技術(shù)在Nuss手術(shù)中的應(yīng)用,并分析該技術(shù)的可行性、便捷性及安全性。方法回顧性分析2012年1月-2015年12月期間收治的76名漏斗胸患者,將其分為指觸組(34例)和對照組(42例)。指觸組是在Nuss手術(shù)中做雙側(cè)腋前線20 mm切口,并建立皮下隧道進(jìn)胸,手指探查胸腔,在胸骨后與對側(cè)胸腔的擴(kuò)展鉗尖端接觸,在確認(rèn)其間無心、肺、膈肌等重要組織后,擴(kuò)展鉗在手指引導(dǎo)下穿過胸骨后組織到相應(yīng)位置,從而避免心、肺等組織損傷,術(shù)中不使用胸腔鏡及鋼板固定器。對照組采用經(jīng)典的Nuss術(shù)式。本文將兩組患者的圍術(shù)期情況、主要并發(fā)癥的發(fā)生率和術(shù)后滿意度進(jìn)行對比分析。結(jié)果 76例患者順利完成手術(shù),平均手術(shù)時(shí)間及術(shù)后平均住院天數(shù)指觸組對照組,(39.10±10.01)min vs(70.15±12.87)min,P=0.028,(2.81±0.71)d vs(4.01±0.81)d,P=0.048。主要并發(fā)癥發(fā)生率指觸組對照組(8.82%vs 26.19%)。兩組患者的術(shù)后滿意度差異無統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論新設(shè)計(jì)的指觸引導(dǎo)技術(shù)可最大限度地避免Nuss術(shù)中心、肺及大血管等重要臟器的損傷,此技術(shù)簡單易行,值得進(jìn)一步推廣應(yīng)用。
[Abstract]:Objective to explore the application of the newly designed finger-guided technique in Nuss surgery, and to analyze the feasibility, convenience and safety of the technique. Methods 76 patients with funnel chest were analyzed retrospectively from January 2012 to December 2015. They were divided into finger touch group (34 cases) and control group (42 cases). In the finger touch group, the bilateral axillary front line incision was performed for 20 mm during Nuss operation, and a subcutaneous tunnel was established to enter the chest cavity, probe the thoracic cavity with the fingers, and contact the tip of the extended forceps behind the sternum, after confirming that there was no heart, lung, diaphragm and other important tissues. The expanded forceps passed through the sternum to the corresponding position under the guidance of fingers to avoid the injury of heart and lung and no thoracoscopy and plate fixator were used during the operation. The control group was treated with classical Nuss procedure. The perioperative period, incidence of major complications and postoperative satisfaction were compared between the two groups. Results 76 patients completed the operation successfully, the average operation time and the average hospitalization days after operation were (39.10 鹵10.01) min vs (70.15 鹵12.87) min,P=0.028, (2.81 鹵0.71) d vs (4.01 鹵0.81 days) in the control group. P0. 048. The incidence of major complications was in the control group (8.82%vs 26.19%). There was no significant difference in postoperative satisfaction between the two groups (P0.05). Conclusion the newly designed finger touch guidance technique can avoid the injury of important organs such as the center of Nuss, lung and large blood vessels to the maximum extent. This technique is simple and easy to use, and it is worthy of further popularization and application.
【作者單位】： 南方醫(yī)科大學(xué)珠江醫(yī)院胸心外科;
【分類號】：R726.5
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本文編號：2322611