Division of Pediatric Surgery, Children's Hospital, The University of Western Ontario, London, Ontario, Canada, N6A 4G5.
J Pediatr Surg. 2013 May;48(5):1055-9. doi: 10.1016/j.jpedsurg.2013.02.028.
The purpose of this study was to examine the effectiveness and patient satisfaction with bracing for pectus carinatum (PC).
Twenty-five PC patients were treated between August 2007 and October 2011. Most patients were male (21/25,84%) with a mean age of 14.4 ± 2.0 yrs. A lightweight, patient controlled, external brace (Braceworks, Calgary, AB) was used. Monthly follow-up with anterior-posterior (AP) width measurements occurred until bracing was completed. Three quality of life (QOL) questionnaires were used: SF-36, SSQ, and PEEQ.
Group 1 involved twenty patients who successfully completed bracing (12/25,56%) or who are still bracing (8/25,32%). Group 2 comprised five patients who failed bracing (2/25,8%) or who were noncompliant (3/25,12%). One patient who failed bracing underwent successful Ravitch repair. AP width decreased more in those with successful bracing (2.31 vs 0.64 cm, p=0.05). Questionnaires were completed by 19/25 (76%) patients. Pre-bracing, the SF-36, and PEEQ revealed that few patients were symptomatic, although most still avoided activities which showed their chest. The SSQ revealed that the majority of patients were very satisfied with their post-bracing appearance, experienced minimal discomfort while bracing, and would use the brace again. Self-esteem increased significantly after bracing (7.5 vs 8.7, p=0.01).
Bracing in PC patients is very effective in a compliant patient with close follow-up. Surgical repair remains feasible if bracing fails.
本研究旨在探讨鸡胸（pectus carinatum，PC）支具治疗的有效性和患者满意度。
2007 年 8 月至 2011 年 10 月，25 例 PC 患者接受治疗。大多数患者为男性（21/25，84%），平均年龄为 14.4±2.0 岁。使用轻便、患者自控、外部支具（Braceworks，卡尔加里，AB）。每月进行一次前后径（AP）宽度测量，直至支具佩戴完成。使用了 3 种生活质量（quality of life，QOL）问卷：SF-36、SSQ 和 PEEQ。
第 1 组包括 20 例成功完成支具治疗（12/25，56%）或仍在支具治疗中的患者（8/25，32%）。第 2 组包括 5 例支具治疗失败（2/25，8%）或不依从的患者（3/25，12%）。1 例支具治疗失败的患者接受了成功的 Ravitch 修复。成功支具治疗的患者 AP 宽度减小更多（2.31 vs 0.64 cm，p=0.05）。25 例患者中有 19 例（76%）完成了问卷。在支具治疗前，SF-36 和 PEEQ 显示，虽然大多数患者仍避免进行可能暴露胸部的活动，但只有少数患者有症状。SSQ 显示，大多数患者对支具治疗后的外观非常满意，支具佩戴期间仅有轻微不适，且愿意再次使用支具。支具治疗后自尊显著提高（7.5 vs 8.7，p=0.01）。
在依从性好、密切随访的患者中，PC 患者的支具治疗非常有效。如果支具治疗失败，仍可行手术修复。
