指触引导技术在Nuss手术中的应用
发布时间：2018-11-10 13:34
【摘要】：目的探讨新设计的指触引导技术在Nuss手术中的应用,并分析该技术的可行性、便捷性及安全性。方法回顾性分析2012年1月-2015年12月期间收治的76名漏斗胸患者,将其分为指触组(34例)和对照组(42例)。指触组是在Nuss手术中做双侧腋前线20 mm切口,并建立皮下隧道进胸,手指探查胸腔,在胸骨后与对侧胸腔的扩展钳尖端接触,在确认其间无心、肺、膈肌等重要组织后,扩展钳在手指引导下穿过胸骨后组织到相应位置,从而避免心、肺等组织损伤,术中不使用胸腔镜及钢板固定器。对照组采用经典的Nuss术式。本文将两组患者的围术期情况、主要并发症的发生率和术后满意度进行对比分析。结果 76例患者顺利完成手术,平均手术时间及术后平均住院天数指触组对照组,(39.10±10.01)min vs(70.15±12.87)min,P=0.028,(2.81±0.71)d vs(4.01±0.81)d,P=0.048。主要并发症发生率指触组对照组(8.82%vs 26.19%)。两组患者的术后满意度差异无统计学意义(P0.05)。结论新设计的指触引导技术可最大限度地避免Nuss术中心、肺及大血管等重要脏器的损伤,此技术简单易行,值得进一步推广应用。
[Abstract]:Objective to explore the application of the newly designed finger-guided technique in Nuss surgery, and to analyze the feasibility, convenience and safety of the technique. Methods 76 patients with funnel chest were analyzed retrospectively from January 2012 to December 2015. They were divided into finger touch group (34 cases) and control group (42 cases). In the finger touch group, the bilateral axillary front line incision was performed for 20 mm during Nuss operation, and a subcutaneous tunnel was established to enter the chest cavity, probe the thoracic cavity with the fingers, and contact the tip of the extended forceps behind the sternum, after confirming that there was no heart, lung, diaphragm and other important tissues. The expanded forceps passed through the sternum to the corresponding position under the guidance of fingers to avoid the injury of heart and lung and no thoracoscopy and plate fixator were used during the operation. The control group was treated with classical Nuss procedure. The perioperative period, incidence of major complications and postoperative satisfaction were compared between the two groups. Results 76 patients completed the operation successfully, the average operation time and the average hospitalization days after operation were (39.10 卤10.01) min vs (70.15 卤12.87) min,P=0.028, (2.81 卤0.71) d vs (4.01 卤0.81 days) in the control group. P0. 048. The incidence of major complications was in the control group (8.82%vs 26.19%). There was no significant difference in postoperative satisfaction between the two groups (P0.05). Conclusion the newly designed finger touch guidance technique can avoid the injury of important organs such as the center of Nuss, lung and large blood vessels to the maximum extent. This technique is simple and easy to use, and it is worthy of further popularization and application.
【作者单位】： 南方医科大学珠江医院胸心外科;
【分类号】：R726.5
，
本文编号：2322611
[Abstract]:Objective to explore the application of the newly designed finger-guided technique in Nuss surgery, and to analyze the feasibility, convenience and safety of the technique. Methods 76 patients with funnel chest were analyzed retrospectively from January 2012 to December 2015. They were divided into finger touch group (34 cases) and control group (42 cases). In the finger touch group, the bilateral axillary front line incision was performed for 20 mm during Nuss operation, and a subcutaneous tunnel was established to enter the chest cavity, probe the thoracic cavity with the fingers, and contact the tip of the extended forceps behind the sternum, after confirming that there was no heart, lung, diaphragm and other important tissues. The expanded forceps passed through the sternum to the corresponding position under the guidance of fingers to avoid the injury of heart and lung and no thoracoscopy and plate fixator were used during the operation. The control group was treated with classical Nuss procedure. The perioperative period, incidence of major complications and postoperative satisfaction were compared between the two groups. Results 76 patients completed the operation successfully, the average operation time and the average hospitalization days after operation were (39.10 卤10.01) min vs (70.15 卤12.87) min,P=0.028, (2.81 卤0.71) d vs (4.01 卤0.81 days) in the control group. P0. 048. The incidence of major complications was in the control group (8.82%vs 26.19%). There was no significant difference in postoperative satisfaction between the two groups (P0.05). Conclusion the newly designed finger touch guidance technique can avoid the injury of important organs such as the center of Nuss, lung and large blood vessels to the maximum extent. This technique is simple and easy to use, and it is worthy of further popularization and application.
【作者单位】： 南方医科大学珠江医院胸心外科;
【分类号】：R726.5
，
本文编号：2322611
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