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鸡胸12年非手术治疗结果

[Result of 12 years of non-surgical treatment of pectus carinatum].

作者信息

Rosière N I, Gutiérrez R, Madrid C, Mendoza M, Martínez A, Bellia-Munzón G

机构信息

Servicio de Cirugía Torácica. Hospital General de Niños "Dr. Pedro de Elizalde". Ciudad Autónoma de Buenos Aires, Argentina.

出版信息

Cir Pediatr. 2018 Aug 3;31(3):115-120.

Abstract

OBJECTIVE

To report our experience in the treatment of pectus carinatum by using the dynamic compression system.

MATERIAL AND METHODS

Retrospective study during the period from January 2005 to September 2017. Patients with typical condrogladiolar pectus carinatum and correction pressure (PC) ≤ 14 PSI (pound square inch) were included. Exclusion criteria: patients with previous thoracic surgery, mixed malformations and chondromanubrial pectus carinatum. For the treatment, the Dynamic Thoracic Compressor System (FMF) with pressure meter in PSI was used. The PC, the treatment pressure (PT), the correction time (TC) and the maintenance time (TM), recurrences and complications were analyzed. A qualitative scale was measured in three grades: where A is excellent or very good, B is regular and C is bad.

RESULTS

We treated 104 patients under 18 years of age. The PT was 2.26. The average of the TC was 8.8 months. The TM was on average 8 months. 36.5% of the patients finished the treatment, 36.5% still continue in treatment and 26.9% of the patients lost the follow-up due to desertion. The qualitative assessment was positive in 95.5% of our patients, and unfavourable in 4.5%.

CONCLUSION

The non-surgical treatment of pectus carinatum is efficient, non-invasive and of low morbidity. Regarding the high dropout rate, we must analyze the variables to be modified to reduce it. This treatment should be considered as the first option to correct pectus carinatum in patients with flexible thorax.

摘要

目的

报告我们使用动态加压系统治疗鸡胸的经验。

材料与方法

回顾性研究,研究时间为2005年1月至2017年9月。纳入典型软骨胸骨型鸡胸且矫正压力(PC)≤14磅力/平方英寸(PSI)的患者。排除标准:既往有胸外科手术史、合并畸形及软骨柄状鸡胸患者。治疗采用带PSI压力计的动态胸廓压缩系统(FMF)。分析PC、治疗压力(PT)、矫正时间(TC)、维持时间(TM)、复发情况及并发症。采用定性量表进行三级评估:A为优或良,B为一般,C为差。

结果

我们治疗了104例18岁以下患者。PT为2.26。TC平均为8.8个月。TM平均为8个月。36.5%的患者完成治疗,36.5%仍在继续治疗,26.9%的患者因放弃治疗而失访。95.5%的患者定性评估为阳性,4.5%为阴性。

结论

鸡胸的非手术治疗有效、无创且发病率低。鉴于高失访率,我们必须分析需要调整的变量以降低失访率。对于胸廓柔韧的患者,这种治疗应被视为矫正鸡胸的首选方法。

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