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[儿童鸡胸的外科治疗]

[Surgical treatment of pectus carinatum in children].

作者信息

Narkhodzhaev N S, Turmetov I Zh, Karabekov A K

机构信息

Yasavi International Kazakh-Turkish University, Turkestan, Kazakhstan; South Kazakhstan Regional Children's Hospital, Shymkent, Kazakhstan; South Kazakhstan State Pharmaceutical Academy, Medical Faculty, Shymkent, Kazakhstan.

Yasavi International Kazakh-Turkish University, Turkestan, Kazakhstan.

出版信息

Khirurgiia (Mosk). 2018(5):81-85. doi: 10.17116/hirurgia2018581-85.

Abstract

AIM

To improve the results of surgical treatment of pectus carinatum.

MATERIAL AND METHODS

The work included 47 pectus carinatum patients aged 3-15 years for the period from 2000 to 2015. All patients were divided into 2 groups depending on surgical approach: control group - 23 (48.94%) children who underwent thoracoplasty by M.M. Ravitsh procedure with the use of device for pectus carinatum repair of our design; main group - 24 (51.06%) patients where our method of thoracoplasty based on changes of deformed ribs biomechanics was used.

RESULTS

In control group good results were obtained in 15 (65.3%) patients, satisfactory - in 5 (21.7%) patients, recurrent deformation with all consequences was observed in 3 (13%) cases. Long-term results of surgical treatment by original method were followed-up in all 24 patients and good outcomes were obtained in 100% of children.

CONCLUSION

  1. Intraoperative 'spring' - effect is a provoking risk factor of recurrent chest deformation. 2) The new surgical method based on breaking the ribs bodies in 'green branch' fashion provides good results and does not require external devices to hold sternal-rib complex in corrected position.
摘要

目的

提高鸡胸手术治疗效果。

材料与方法

研究纳入了2000年至2015年期间47例年龄在3至15岁的鸡胸患者。根据手术方式,所有患者被分为2组:对照组——23例(48.94%)儿童,采用我们设计的用于鸡胸修复的装置,通过M.M.拉维茨手术进行胸廓成形术;主要组——24例(51.06%)患者,采用基于变形肋骨生物力学改变的胸廓成形术方法。

结果

对照组中,15例(65.3%)患者取得良好效果,5例(21.7%)患者效果满意,3例(13%)出现复发畸形及所有相关后果。对所有24例采用原方法进行手术治疗的患者进行了长期随访,所有儿童均取得良好结果。

结论

1)术中“弹簧”效应是胸部复发畸形的诱发危险因素。2)基于以“青枝”方式折断肋骨体的新手术方法效果良好,且无需外部装置将胸骨 - 肋骨复合体固定在矫正位置。

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