本文選題：兒童正常胸廓 + 測量��； 參考：《中南大學》2013年碩士論文

【摘要】：目的：小兒胸廓畸形最常見于漏斗胸,Haller指數(shù)是公認評價漏斗胸胸骨凹陷程度的一個最佳指標；目前治療漏斗胸主要是采用微創(chuàng)矯形術(shù)(Nuss術(shù)),Nuss術(shù)的最佳年齡在6～12歲,可擴展至3-15歲,在臨床實際工作當中一般是將Nuss手術(shù)患者年齡掌握在3歲以上；Nuss手術(shù)的成功主要是基于預先彎曲成形為患者所需的適合前胸壁曲度的支撐鋼板的選擇,那么對于漏斗胸Nuss手術(shù)需要矯正到什么程度,同時還必須考慮到2-3年后取支撐鋼板時胸廓會發(fā)育到什么情況,這就需要有一個量化的胸廓標準及其發(fā)育趨勢,迄今,國內(nèi)還沒有基于MSCT對我國兒童正常胸廓值、Haller指數(shù)的測量研究報告,所以本課題收集3-12歲兒童正常胸廓的MSCT片,以測量中國兒童的正常胸廓徑線及Haller指數(shù),希望能為兒童胸廓生長發(fā)育的基礎性研究以及漏斗胸的外科矯治和隨訪提供一些有益的參考。 方法：選取2011年5月～2012年12月年在我院就診的無胸廓畸形的3-12歲兒童胸部MSCT片樣本411例。按照性別分為兩組：男、女各一組,男組共214例,女組共197例。再按照年齡分組,每一歲為一組,男、女各10組,總共20組；分別測量左、右兩側(cè)胸廓高度、胸廓最大橫內(nèi)徑、胸骨上端及胸骨下端的胸廓前后徑、Haller指數(shù)；每個變量測量3次,并取其均值；并所有數(shù)據(jù)均由作者一人錄入數(shù)據(jù)庫,并采用SPSS軟件進行數(shù)據(jù)分析。 結(jié)果：胸廓各徑線與年齡呈正相關(guān),隨著年齡增長而增長；兒童胸廓高度、胸廓橫徑的生長變化具有一定的同步性,均在3-7歲增長快速呈生長高峰期,7-11歲生長較平穩(wěn)呈生長的平臺期,在11-12歲生長速率再次加快呈小高峰期。胸廓前后徑的生長變化與胸廓高度、胸廓橫徑的生長變化并不是完全同步。男性和女性的Haller指數(shù)隨年齡的增長大致呈上升趨勢,3歲到12歲男性的Haller指數(shù)在2.33-2.52間波動,女性的Haller指數(shù)在2.31-2.63間波動；不同年齡組的男性和女性的Haller指數(shù)差異均無統(tǒng)計學意義。 結(jié)論：1.中國兒童胸廓生長發(fā)育具有其一定的獨特性；本研究的測量值可以為漏斗胸的矯正手術(shù)方案制定、術(shù)后隨訪提供一些有益的幫助。2.Haller指數(shù)是一個比較穩(wěn)定的參數(shù),可以作為漏斗胸診治的一個重要參考指標。(圖23幅,表18個,參考文獻77篇。)
[Abstract]:Objective: the Haller index of pectoral deformity in children is the best index to evaluate the degree of sternum depression in pectus excavatum, and the best age for the treatment of pectorus excavatum is to use minimally invasive orthoplasty (Nuss). It can be extended to 3 to 15 years old. In clinical practice, the success of Nuss surgery is mainly based on the choice of bracing plate suitable for the curvature of the anterior chest wall, which is suitable for the patient. So what's the extent to which Nuss surgery for funnel chest needs to be corrected, and we have to take into account what will happen to the chest in 2-3 years when we take the supporting plate, which requires a quantitative thoracic standard and its developmental trends, so far, There is no report on the measurement of normal thorax value and Haller index based on MSCT in China. Therefore, MSCT films of normal thorax of children aged 3-12 years are collected in this paper to measure the normal thoracic diameter and Haller index of Chinese children. It is hoped that it can provide some useful reference for the basic study of thorax growth and development in children and the surgical treatment and follow-up of funnel chest. Methods: from May 2011 to December 2012, 411 cases of 3-12 years old children without thoracic malformation were selected. The patients were divided into two groups according to sex: male group, female group, 214 cases in male group and 197 cases in female group. They were divided into groups according to their age, male and female, 10 groups, totally 20 groups. The left and right sides of thoracic height, the maximum transverse diameter of chest, the anterior and posterior diameter of chest and the Haller index of the upper and lower sternum were measured 3 times per variable. All the data are entered into the database by the author and analyzed by SPSS software. Results: there was a positive correlation between the diameter of chest and age, which increased with the increase of age, and the changes of the height and transverse diameter of thorax in children had a certain synchronism. The growth rate increased rapidly from 3 to 7 years old at the plateau stage of steady growth between 7 and 11 years old, and accelerated again at 11 to 12 years old, and showed a small peak period at the age of 11 to 12 years. The growth changes of the anteroposterior diameter of the chest and the height of the thorax and the growth of the transverse diameter of the chest are not completely synchronized. The Haller index of male and female increased with the increase of age. The Haller index of male from 3 to 12 years old fluctuated from 2.33 to 2.52, and that of female from 2.31 to 2.63. There was no significant difference in Haller index between male and female in different age groups. Conclusion 1. The growth and development of Chinese children's thorax has its own uniqueness, the measured values of this study can be used to formulate the orthodontic surgery plan of funnel chest, and the follow-up after operation provides some useful help. 2. Haller index is a relatively stable parameter. It can be used as an important reference index for diagnosis and treatment of funnel chest. (23 figs, 18 tables, 77 refs.)
【學位授予單位】：中南大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R816.8

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