基于MSCT三维成像测量中国3～12岁儿童胸廓正常值

发布时间：2018-06-25 03:20

本文选题：儿童正常胸廓 + 测量　；参考：《中南大学》2013年硕士论文

【摘要】：目的：小儿胸廓畸形最常见于漏斗胸,Haller指数是公认评价漏斗胸胸骨凹陷程度的一个最佳指标；目前治疗漏斗胸主要是采用微创矫形术(Nuss术),Nuss术的最佳年龄在6～12岁,可扩展至3-15岁,在临床实际工作当中一般是将Nuss手术患者年龄掌握在3岁以上；Nuss手术的成功主要是基于预先弯曲成形为患者所需的适合前胸壁曲度的支撑钢板的选择,那么对于漏斗胸Nuss手术需要矫正到什么程度,同时还必须考虑到2-3年后取支撑钢板时胸廓会发育到什么情况,这就需要有一个量化的胸廓标准及其发育趋势,迄今,国内还没有基于MSCT对我国儿童正常胸廓值、Haller指数的测量研究报告,所以本课题收集3-12岁儿童正常胸廓的MSCT片,以测量中国儿童的正常胸廓径线及Haller指数,希望能为儿童胸廓生长发育的基础性研究以及漏斗胸的外科矫治和随访提供一些有益的参考。方法：选取2011年5月～2012年12月年在我院就诊的无胸廓畸形的3-12岁儿童胸部MSCT片样本411例。按照性别分为两组：男、女各一组,男组共214例,女组共197例。再按照年龄分组,每一岁为一组,男、女各10组,总共20组；分别测量左、右两侧胸廓高度、胸廓最大横内径、胸骨上端及胸骨下端的胸廓前后径、Haller指数；每个变量测量3次,并取其均值；并所有数据均由作者一人录入数据库,并采用SPSS软件进行数据分析。结果：胸廓各径线与年龄呈正相关,随着年龄增长而增长；儿童胸廓高度、胸廓横径的生长变化具有一定的同步性,均在3-7岁增长快速呈生长高峰期,7-11岁生长较平稳呈生长的平台期,在11-12岁生长速率再次加快呈小高峰期。胸廓前后径的生长变化与胸廓高度、胸廓横径的生长变化并不是完全同步。男性和女性的Haller指数随年龄的增长大致呈上升趋势,3岁到12岁男性的Haller指数在2.33-2.52间波动,女性的Haller指数在2.31-2.63间波动；不同年龄组的男性和女性的Haller指数差异均无统计学意义。结论：1.中国儿童胸廓生长发育具有其一定的独特性；本研究的测量值可以为漏斗胸的矫正手术方案制定、术后随访提供一些有益的帮助。2.Haller指数是一个比较稳定的参数,可以作为漏斗胸诊治的一个重要参考指标。(图23幅,表18个,参考文献77篇。)
[Abstract]:Objective: the Haller index of pectoral deformity in children is the best index to evaluate the degree of sternum depression in pectus excavatum, and the best age for the treatment of pectorus excavatum is to use minimally invasive orthoplasty (Nuss). It can be extended to 3 to 15 years old. In clinical practice, the success of Nuss surgery is mainly based on the choice of bracing plate suitable for the curvature of the anterior chest wall, which is suitable for the patient. So what's the extent to which Nuss surgery for funnel chest needs to be corrected, and we have to take into account what will happen to the chest in 2-3 years when we take the supporting plate, which requires a quantitative thoracic standard and its developmental trends, so far, There is no report on the measurement of normal thorax value and Haller index based on MSCT in China. Therefore, MSCT films of normal thorax of children aged 3-12 years are collected in this paper to measure the normal thoracic diameter and Haller index of Chinese children. It is hoped that it can provide some useful reference for the basic study of thorax growth and development in children and the surgical treatment and follow-up of funnel chest. Methods: from May 2011 to December 2012, 411 cases of 3-12 years old children without thoracic malformation were selected. The patients were divided into two groups according to sex: male group, female group, 214 cases in male group and 197 cases in female group. They were divided into groups according to their age, male and female, 10 groups, totally 20 groups. The left and right sides of thoracic height, the maximum transverse diameter of chest, the anterior and posterior diameter of chest and the Haller index of the upper and lower sternum were measured 3 times per variable. All the data are entered into the database by the author and analyzed by SPSS software. Results: there was a positive correlation between the diameter of chest and age, which increased with the increase of age, and the changes of the height and transverse diameter of thorax in children had a certain synchronism. The growth rate increased rapidly from 3 to 7 years old at the plateau stage of steady growth between 7 and 11 years old, and accelerated again at 11 to 12 years old, and showed a small peak period at the age of 11 to 12 years. The growth changes of the anteroposterior diameter of the chest and the height of the thorax and the growth of the transverse diameter of the chest are not completely synchronized. The Haller index of male and female increased with the increase of age. The Haller index of male from 3 to 12 years old fluctuated from 2.33 to 2.52, and that of female from 2.31 to 2.63. There was no significant difference in Haller index between male and female in different age groups. Conclusion 1. The growth and development of Chinese children's thorax has its own uniqueness, the measured values of this study can be used to formulate the orthodontic surgery plan of funnel chest, and the follow-up after operation provides some useful help. 2. Haller index is a relatively stable parameter. It can be used as an important reference index for diagnosis and treatment of funnel chest. (23 figs, 18 tables, 77 refs.)
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R816.8

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