Department of Paediatric Surgery, Women's and Children's Hospital, North Adelaide, South Australia, Australia.
J Pediatr Surg. 2012 Aug;47(8):1506-11. doi: 10.1016/j.jpedsurg.2012.02.005.
Metal implants may wear and corrode, resulting in systemic dissemination of metallic debris that is measurable in serum. Concern exists regarding adverse health effects related to implant-derived debris. Minimally invasive repair of pectus excavatum (MIRPE) is a popular technique in which a stainless steel substernal bar is implanted to achieve deformity correction. Serum metal levels have not previously been investigated after MIRPE.
Serum chromium, molybdenum, and nickel levels were measured in this cross-sectional study of 11 children implanted with pectus bars after MIRPE. Samples were analyzed using high-resolution inductively coupled plasma mass spectrometry.
Median serum chromium and nickel values were elevated 3.3-fold (P = .0003) and 2.3-fold (P = .25), respectively, compared with age-matched controls. Serum chromium and nickel levels were abnormally elevated in 6 (55%) of 11 and 5 (45%) of 11, respectively. In patients whom postexplantation metal levels were measured, previously elevated levels were lowered. Serum chromium levels in children after MIRPE are comparable with adult cohorts with hip arthroplasty implants measured 1-year postoperatively. No acute metal toxicity was observed.
Abnormally elevated levels of serum metal levels are measurable in children implanted with pectus bars. These findings warrant further investigation to assess the biocompatibility of this surgical implant in children.
金属植入物可能会磨损和腐蚀，导致金属碎片在血清中被测量到系统传播。人们对与植入物衍生的碎片有关的不良健康影响表示关注。微创漏斗胸修复术（MIRPE）是一种流行的技术，其中植入不锈钢胸骨下棒以实现畸形矫正。以前没有研究过 MIRPE 后血清金属水平。
本横断面研究对 11 名接受 MIRPE 后植入胸骨下棒的儿童进行了血清铬、钼和镍水平的测量。使用高分辨率电感耦合等离子体质谱法对样品进行分析。
与年龄匹配的对照组相比，中位数血清铬和镍值分别升高了 3.3 倍（P =.0003）和 2.3 倍（P =.25）。11 名患者中有 6 名（55%）和 11 名患者中有 5 名（45%）血清铬和镍水平异常升高。在测量了金属取出后水平的患者中，先前升高的水平降低了。MIRPE 后儿童的血清铬水平与接受髋关节置换植入物术后 1 年的成人队列相当。未观察到急性金属毒性。
在植入胸骨下棒的儿童中可测量到血清金属水平异常升高。这些发现需要进一步研究，以评估这种手术植入物在儿童中的生物相容性。
