Oswald Nicola, Jalal Zara, Kadiri Salma, Naidu Babu
Institute of Inflammation and Ageing, College of Medical and Dental Sciences, Centre for Translational Inflammation Research, University of Birmingham Laboratories, Queen Elizabeth Hospital Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
Department of Thoracic Research, Heartlands Hospital, Birmingham, B9 5SS, UK.
J Cardiothorac Surg. 2019 Jan 8;14(1):4. doi: 10.1186/s13019-018-0827-1.
The effects of the Nuss procedure on chest wall motion and spirometry have previously been described; we aimed to describe the effects of removal of the Nuss bar.
We studied 9 patients just prior to and 6 weeks after Nuss bar removal. Regional chest volume changes, synchrony of respiratory movement and spirometry were recorded using optoelectronic plethysmography (OEP) and compared. Recordings were performed at rest and exercise during cycle ergometry.
There were small but statistically significant changes in tidal volumes of the diaphragmatic ribcage compartment during exercise (+ 48 ml, p = 0.038, Cohen's d = 0.12) and percentage contribution of the diaphragmatic ribcage to total tidal volumes at rest (+ 2.7 percentage points, p = 0.038, Cohen's d = 0.12). Synchrony of respiratory movements at rest and during exercise was unchanged following Nuss bar removal. There were no significant changes in spirometry and exercise capacity.
The effects of Nuss bar removal on diaphragmatic ribcage motion are detectable but small and unlikely to be of clinical significance. No change in exercise capacity should be expected after Nuss bar removal.
Registered at ClinicalTrials.gov, identifier NCT02958683 , registered 5th August 2016, first patient enrolled July 2016, retrospectively registered.
此前已有关于努斯手术对胸壁运动和肺量计检查影响的描述；我们旨在描述取出努斯棒的影响。
我们对9例患者在取出努斯棒前及取出后6周进行了研究。使用光电体积描记法（OEP）记录并比较局部胸壁容积变化、呼吸运动同步性和肺量计检查结果。在静息状态和蹬车运动期间进行记录。
运动期间膈肌胸廓腔的潮气量有微小但具有统计学意义的变化（增加48毫升，p = 0.038，科恩d值 = 0.12），静息时膈肌胸廓腔对总潮气量的贡献百分比增加（增加2.7个百分点，p = 0.038，科恩d值 = 0.1）。取出努斯棒后，静息和运动时呼吸运动的同步性未改变。肺量计检查和运动能力无显著变化。
取出努斯棒对膈肌胸廓运动的影响可检测到，但较小，可能无临床意义。取出努斯棒后预计运动能力不会改变。
在ClinicalTrials.gov注册，标识符NCT02958683，2016年8月5日注册，首例患者于2016年7月入组，回顾性注册。
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