漏斗胸微创修复术后的微量金属释放
Trace metal release after minimally-invasive repair of pectus excavatum.
作者信息
Fortmann Caroline, Göen Thomas, Krüger Marcus, Ure Benno M, Petersen Claus, Kübler Joachim F
机构信息
Department of Pediatric Surgery, Hannover Medical School, Hannover, Germany.
Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany.
出版信息
PLoS One. 2017 Oct 12;12(10):e0186323. doi: 10.1371/journal.pone.0186323. eCollection 2017.
BACKGROUND
Several studies have shown a high incidence of metal allergy after minimally-invasive repair of pectus excavatum (MIRPE). We postulated that MIRPE is associated with a significant release of trace metal ions, possibly causing the allergic symptoms.
METHODS
We evaluated the concentration with chromium, cobalt and nickel in blood, urine and tissue in patients prior to MIRPE and in patients who underwent an explantation of the stainless-steel bar(s) after three years.
RESULTS
Our study group consisted of 20 patients (mean age 19 years) who had bar explantation and our control group included 20 patients (mean age 16 years) prior to MIRPE. At the time of bar removal we detected significantly elevated concentrations of chromium and nickel in the tissue compared to patients prior to the procedure (p<0,001). We also found a significant increase in the levels of chromium in urine and nickel in blood in patients three years post MIRPE (p<0,001). Four patients temporarily developed symptoms of metal allergy, all had elevated metal values in blood and urine at explantation.
CONCLUSIONS
Minimally-invasive repair of pectus excavatum can lead to a significant trace metal exposure.
背景
多项研究表明，漏斗胸微创修复术（MIRPE）后金属过敏的发生率很高。我们推测，MIRPE与微量金属离子的大量释放有关，这可能会引发过敏症状。
方法
我们评估了接受MIRPE手术前患者以及三年后接受不锈钢棒取出术患者血液、尿液和组织中的铬、钴和镍浓度。
结果
我们的研究组由20名接受棒取出术的患者（平均年龄19岁）组成，对照组包括20名接受MIRPE手术前的患者（平均年龄16岁）。在取出棒时，我们检测到组织中的铬和镍浓度与手术前患者相比显著升高（p<0.001）。我们还发现，MIRPE术后三年患者尿液中的铬水平和血液中的镍水平显著增加（p<0.001）。四名患者暂时出现金属过敏症状，所有患者在取出棒时血液和尿液中的金属值均升高。
结论
漏斗胸微创修复术可导致大量微量金属暴露。
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