Department of Plastic and Reconstructive Surgery, School of Medicine, Keio University, Tokyo, Japan.
Eur J Cardiothorac Surg. 2010 Aug;38(2):203-8. doi: 10.1016/j.ejcts.2009.12.047. Epub 2010 Feb 21.
The present study aims to evaluate age-related change of postoperative pain after the Nuss procedure by referring to clinical cases, and to elucidate the biomechanical aetiology of the change by using the finite element method.
Twelve paediatric patients (paediatric group: 9.4+/-2.3 years old) and 13 adult patients (adult group: 26.3+/-5.5 years old) who received the Nuss procedure for pectus excavatum were included in the study. On the second postoperative day, the patients were asked to indicate regions on the thorax where they felt the greatest pain. The locations of these regions were compared between the two groups. In addition, stress-distribution patterns were examined using finite element models produced by simulating the thoraces of the patients. The stress-distribution patterns were compared between the two groups.
The patients of the paediatric group and adult group tend to have pain on the anterior and posterior regions of the thorax, respectively. The finite element study revealed that paediatric thoraces and adult thoraces develop intensified stresses in the anterior region and the posterior region, respectively.
Postoperative pain tends to occur in the anterior part of the thorax for paediatric patients and in the posterior part of the thorax for adult patients, reflecting the stress distributions of these two distinct patient populations.
本研究旨在通过临床病例评估 Nuss 手术后与年龄相关的术后疼痛变化，并通过有限元法阐明变化的生物力学病因。
纳入 12 例儿科患者（儿科组：9.4+/-2.3 岁）和 13 例成人患者（成人组：26.3+/-5.5 岁），他们均因漏斗胸接受了 Nuss 手术。术后第 2 天，患者被要求指出胸部感到最痛的区域。比较两组患者的这些区域的位置。此外，还通过模拟患者胸部制作有限元模型来检查应力分布模式。比较两组之间的应力分布模式。
儿科组和成人组的患者分别倾向于在前胸部和后胸部出现疼痛。有限元研究表明，儿科胸廓和成人胸廓在前区和后区分别产生强化的应力。
儿科患者术后疼痛倾向于发生在前胸部，而成人患者术后疼痛倾向于发生在后胸部，这反映了这两种不同患者群体的应力分布情况。
