Das Bibhuti B, Recto Michael R, Yeh Thomas
Division of Pediatric Cardiology, Joe DiMaggio Children's Hospital Heart Institute, Hollywood, FL, USA.
Division of Pediatric Cardiology, Children's Hospital of Orange County, Orange, CA, USA.
Ann Pediatr Cardiol. 2019 May-Aug;12(2):77-82. doi: 10.4103/apc.APC_121_18.
Severe pectus excavatum in children may result in cardiorespiratory functional impairment; therefore, we evaluated cardiopulmonary response to exercise before and after the Nuss procedure.
Twenty-four physically active pediatric patients aged 9-18 years with severe pectus excavatum (Haller index >3.25) were included in the study. Cardiopulmonary exercise testing using treadmill and modified Bruce protocol was performed before and after the Nuss procedure.
Maximal oxygen uptake and oxygen pulse improved by 40.6% (32 ± 13-45 ± 10 ml/kg/min; = 0.0001) and 44.4% (9 ± 4-13 ± 5 ml/beat; = 0.03), respectively, after surgical correction of pectus excavatum by Nuss procedure. Significant improvement in maximum voluntary ventilation and minute ventilation after Nuss procedure was also noted.
We found that, after repair of pectus excavatum by Nuss procedure, the exercise capacity as measured by maximal oxygen consumption improved significantly primarily due to increase in oxygen pulse, an indirect measurement of stroke volume.
儿童严重漏斗胸可能导致心肺功能受损；因此，我们评估了努氏手术前后运动时的心肺反应。
本研究纳入了24例年龄在9至18岁之间、身体活跃的患有严重漏斗胸（哈勒指数>3.25）的儿科患者。在努氏手术前后，使用跑步机和改良布鲁斯方案进行心肺运动测试。
通过努氏手术矫正漏斗胸后，最大摄氧量和氧脉搏分别提高了40.6%（从32±13提高到45±10毫升/千克/分钟；P = 0.0001）和44.4%（从9±4提高到13±5毫升/次心跳；P = 0.03）。努氏手术后，最大自主通气量和分钟通气量也有显著改善。
我们发现，通过努氏手术修复漏斗胸后，以最大耗氧量衡量的运动能力显著提高，这主要是由于氧脉搏增加，而氧脉搏是心输出量的间接测量指标。
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