Zeng Qi, Lai Jin-Yao, Wang Xiao-Man, Lee Jhon-Liau, Chia Shu-Ti, Wang Chao-Jan, Chen Jeng-Chang, Chang Pei-Yeh
Department of Thoracic Surgery, Beijing Children Hospital Affiliated to Capital Medical University, Beijing, China.
J Pediatr Surg. 2008 Dec;43(12):2147-50. doi: 10.1016/j.jpedsurg.2008.08.070.
The Nuss procedure is one of the most popular surgeries for correcting pectus excavatum. However, little is known regarding stress and strain on the deformed ribs after inserting the pectus bar. We used ultrasonography to investigate costochondral changes before and after the Nuss procedure.
Ninety-five patients underwent the Nuss procedure between July 2007 and February 2008 at 2 institutions. Chest ultrasonography, specifically of the bones and cartilage, was performed 1 day before and 1 week after the operation.
Postoperatively, all patients showed various degrees of deformation from the second to sixth cartilages bilaterally. The cartilages were not fractured. Of these patients, 28 (29.5%) had significant changes, including acute angulation of the costochondral junction and rib fractures near the pectus bar. These changes were associated with increased age (P < .01) and the degree of postoperative sternum elevation (P < .01). The pectus index and sex were not significant predictors of rib damage.
The Nuss procedure created significant stress and strain over the deformed cartilages. Approximately 29% of the patients showed localized, self-limited costochondral changes via chest ultrasonography.
努斯手术是治疗漏斗胸最常用的手术之一。然而，对于插入鸡胸矫正钢板后变形肋骨上的应力和应变了解甚少。我们采用超声检查来研究努斯手术后肋软骨的变化。
2007年7月至2008年2月期间，两所机构的95例患者接受了努斯手术。在手术前1天和术后1周进行胸部超声检查，特别是对骨骼和软骨的检查。
术后，所有患者双侧第二至第六软骨均出现不同程度的变形。软骨未发生骨折。其中，28例（29.5%）有明显变化，包括肋软骨交界处急性成角和鸡胸矫正钢板附近肋骨骨折。这些变化与年龄增加（P < 0.01）和术后胸骨抬高程度（P < 0.01）有关。漏斗胸指数和性别不是肋骨损伤的显著预测因素。
努斯手术在变形软骨上产生了显著的应力和应变。通过胸部超声检查，约29%的患者出现局限性、自限性肋软骨变化。
