
[内科] 漏鬥胸
Can the congenital rachitis of child, have the funnel chest and many place skeleton maldevelopment treat?
孩子先天佝偻病,有漏鬥胸和多處骨骼發育不良能治療嗎?
Objective To summarize the short-term efficacy and experience of the non-endoscopic surgical treatment of funnel chest in three incisions.
目的總結無腔鏡下三切口手術治療漏鬥胸的近期療效及經驗。
Objective TO review the surgical experience of sternal turnover with rectus muscle pedicle (STO-RMP) and sternal overlapping suture in the treatment of funnel chest and flat chest.
目的總結漏鬥胸及扁平胸施行腹直肌蒂胸骨翻轉術(STO - RMP)及胸骨重疊術的治療經驗和體會。
Methods 11 cases of funnel-chest deformity were treated by Sternoturnover with pedicle of abdominal rectus muscle and 9 cases were treated with preservating up and down vessel pedicle.
方法應用帶腹直肌蒂胸骨翻轉術治療漏鬥胸11例,帶上下血管蒂胸骨翻轉術治療漏鬥胸9例。
漏鬥胸(Funnel Chest)是一種先天性胸壁畸形,醫學上稱為胸骨凹陷(Pectus Excavatum),主要表現為胸骨及相連的肋軟骨向内凹陷,形成類似漏鬥狀的胸腔結構。該症狀多見于兒童及青少年,男性發病率高于女性。
臨床表現
患者胸骨下部明顯向内凹陷,嚴重時可壓迫心髒和肺部,導緻呼吸困難、運動耐力下降或心悸。部分患者伴隨脊柱側彎或肋骨異常生長。
病因與機制
研究認為與遺傳因素和結締組織發育異常相關,如膠原蛋白代謝缺陷導緻肋軟骨過度生長并牽拉胸骨内陷。部分病例與馬凡綜合征等遺傳性疾病有關。
診斷标準
通過胸部CT掃描測量凹陷深度與胸腔橫徑比值(Haller指數),若指數大于3.25則定義為中重度漏鬥胸,需進一步評估心肺功能。
治療方法
輕症可通過物理矯正訓練改善;中重度患者需手術幹預,如Nuss微創手術植入矯形鋼闆,或傳統Ravitch手術切除異常肋軟骨。
漏鬥胸(Funnel Chest),醫學上稱為Pectus Excavatum,是一種先天性胸壁畸形,其核心特征和相關信息如下:
通過漏鬥胸指數(Funnel-Chest Index, FI) 量化評估,公式為:
$$
FI = frac{凹陷橫徑 times 凹陷縱徑 times 凹陷深度}{胸骨長度 times 胸廓橫徑 times 胸骨角至椎體距離}
$$
如需進一步了解診斷或手術細節,建議參考胸外科權威資料。
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