Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.
J Pediatr Surg. 2011 Jun;46(6):1172-6. doi: 10.1016/j.jpedsurg.2011.03.047.
Paradoxical chest wall motion is recognized clinically in pectus excavatum (PE). We report chest wall volume and motion differences between PE patients and unaffected individuals.
A prospective, institutional review board-approved study compared nonoperated PE patients with normal controls (C). Subjects had deep breathing maneuvers captured by infrared cameras. Chest wall volume and excursion were calculated using optoelectronic plethysmography marker reconstruction combined with proprietary software (BTS Bioengineering, Milan, Italy).
One hundred nineteen patients underwent optoelectronic plethysmography analysis (PE: 64, C: 5). Total chest wall volume at rest was similar in both groups (PE: 13.6 L, C: 14.1 L, P = .55). During maximal inspiration, PE patients had a significant increase in the volume within the abdominal rib cage compartment (PE: 0.77 L, C: 0.6 L, P < .01). Patients with PE had 51% less midline marker excursion at the angle of Louis (P < .01), a 46% decrease at the level of the nipples (P < .01), and 28% less excursion at the xiphoid process (P = .02). At the level of the umbilicus, PE patients had 147% increase in midline marker excursion compared with controls (P < .01).
Optoelectronic plethysmography kinematic analysis allows for quantification of focal chest wall motion dysfunction. Patients with PE demonstrate significantly decreased chest wall motion at the area of the pectus defect and increased abdominal contributions to respiration compared with controls. This finding may help to explain exertional symptoms of easy fatigability or shortness of breath in PE.
漏斗胸（PE）患者临床上可出现反常的胸壁运动。我们报告了 PE 患者与正常对照者之间的胸壁容积和运动差异。
一项前瞻性、机构审查委员会批准的研究比较了未手术的 PE 患者与正常对照者（C）。受试者通过红外摄像机进行深呼吸动作捕捉。使用光电体积描记术标记重建结合专有软件（BTS Bioengineering，米兰，意大利）计算胸壁容积和位移。
119 例患者接受光电体积描记术分析（PE：64 例，C：5 例）。两组患者在休息时的总胸壁容积相似（PE：13.6L，C：14.1L，P=0.55）。在最大吸气时，PE 患者的腹部肋骨腔隔间容积明显增加（PE：0.77L，C：0.6L，P<0.01）。PE 患者在路易角的中线标记位移减少 51%（P<0.01），乳头水平减少 46%（P<0.01），剑突水平减少 28%（P=0.02）。在脐水平，PE 患者的中线标记位移比对照组增加 147%（P<0.01）。
光电体积描记术运动学分析可定量评估局灶性胸壁运动功能障碍。与对照组相比，PE 患者在漏斗胸缺损区域的胸壁运动明显减少，而腹部对呼吸的贡献增加。这一发现可能有助于解释 PE 患者易疲劳或呼吸急促的运动症状。
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