切换至 "中华医学电子期刊资源库"

中华肺部疾病杂志(电子版) ›› 2024, Vol. 17 ›› Issue (01) : 156 -158. doi: 10.3877/cma.j.issn.1674-6902.2024.01.035

病例报告

胸腔镜下微创漏斗胸矫治术中心脏破裂抢救成功2例
刘燕1,(), 卫新1   
  1. 1. 450052 郑州,郑州大学第一附属医院麻醉与围术期医学部
  • 收稿日期:2024-01-05 出版日期:2024-02-25
  • 通信作者: 刘燕

Two cases of successful treatment of cardiac rupture during thoracoscopic minimally invasive infundibular chest correction

Yan Liu(), Xin Wei   

  • Received:2024-01-05 Published:2024-02-25
  • Corresponding author: Yan Liu
引用本文:

刘燕, 卫新. 胸腔镜下微创漏斗胸矫治术中心脏破裂抢救成功2例[J]. 中华肺部疾病杂志(电子版), 2024, 17(01): 156-158.

Yan Liu, Xin Wei. Two cases of successful treatment of cardiac rupture during thoracoscopic minimally invasive infundibular chest correction[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(01): 156-158.

漏斗胸(pectus excavatum, PE)是临床上常见的一种小儿前胸壁漏斗畸形,是由肋软骨过度生长导致的前胸壁凹陷所致。漏斗胸的治疗以手术方法为主[1]。既往的手术修复方法包括Ravitch手术、保留肋软骨的改良Ravitch手术、胸骨翻转手术、微创漏斗胸矫治术等,其中最有效的治疗方式是微创漏斗胸矫治术,其特点是创伤最小,手术时间短,术后恢复快[2,3,4,5]。但该手术也可能会有一些严重并发症,其中心脏并发症包括心脏切开术后综合征(0.4%)、心包炎(0.4%~5%)和心包积液(0.2%~2.4%)[6]。严重畸形、复发性漏斗胸和心脏手术史可造成胸腔或胸骨后黏连,导致大出血、心脏穿孔等严重并发症的概率大大上升[7]。本文对我院胸腔镜下漏斗胸微创矫治术中心脏破裂抢救成功2例进行分析,报道如下。

1
Beltsios ET, Mitsos SL, Panagiotopoulos NT. Pectus excavatum and scoliosis: a review about the patient′s surgical management[J]. Gen Thorac Cardiovasc Surg, 2020, 68(11): 1225-1233.
2
Mao YZ, Tang S, Li S. Comparison of the Nuss versus Ravitch procedure for pectus excavatum repair: an updated meta-analysis[J]. J Pediatr Surg, 2017, 52(10): 1545-1552.
3
Dingeldein MW, Lu CY, Kim AW, et al. Simultaneous costal cartilage-sparing modified Ravitch procedure and latissimus dorsi transfer for chest wall deformity repair in Poland′s syndrome[J]. J Pediatr Surg, 2009, 44(1): e29-32.
4
Brochhausen C, Turial S, Müller FK,et al. Pectus excavatum: history, hypotheses and treatment options[J]. Interact Cardiovasc Thorac Surg, 2012, 14(6): 801-806.
5
Aly MR, Farina JM, Botros MM, et al. Minimally invasive repair of pectus excavatum in adults: a review article of presentation, workup, and surgical treatment[J]. J Thorac Dis, 2023, 15(9): 5150-5173.
6
Haecker FM, Berberich T, Mayr J, et al. Near-fatal bleeding after transmyocardial ventricle lesion during removal of the pectus bar after the Nuss procedure[J]. J Thorac Cardiovasc Surg, 2009, 138(5): 1240-1241.
7
Beati F, Frediani S, Pardi V, et al. Case report-Every thoracic surgeon′s nightmare: cardiac and lung perforation during placement of Nuss bar for pectus excavatum[J]. Front Pediatr, 2023, 11: 1241273.
8
Al-Qadi MO. Disorders of the chest wall: Clinical manifestations[J]. Clin Chest Med, 2018, 39(2): 361-375.
9
Alaca N, Yüksel M. Comparison of physical functions and psychosocial conditions between adolescents with pectus excavatum, pectus carinatum and healthy controls[J]. Pediatr Surg Int, 2021, 37(6): 765-775.
10
Koumbourlis AC. Pectus excavatum: pathophysiology and clinical characteristics[J]. Paediatr Respir Rev, 2009, 10(1): 3-6.
11
Sesia SB, Heitzelmann M, Schaedelin S, et al. Standardized haller and asymmetry index combined for a more accurate assessment of pectus excavatum[J]. Ann Thorac Surg, 2019, 107(1): 271-276.
12
洪文娟,太 祥,洪志鹏,等. 微创漏斗胸修复手术前后患者心肺运动功能的临床观察[J/CD]. 中华肺部疾病杂志(电子版), 2012, 5(3): 226-232.
13
Liu Q, Wang W, Hong C, et al. Effect of minimally invasive repair of pectus excavatum on postoperative chest flatness, cardiopulmonary function, and bone metabolism indexes in children at different ages[J]. Am J Transl Res, 2022, 14(6): 3955-3963.
14
Yoshida A, Uemura S, Yamamoto M, et al. Correlation of asymmetric chest wall deformity and growth in patients with pectus excavatum[J]. J Pediatr Surg, 2013, 48(4): 771-775.
15
周巧梅,屠伟峰,陈 茜. 成人微创漏斗胸矫形术中心脏破裂麻醉处理一例[J]. 临床麻醉学杂志2013, 29(6): 550.
16
王庆峰,王新康. 儿童先天性漏斗胸胸廓畸形与心电图异常的关系[J]. 天津医药2021, 49(8): 856-860.
17
Huang YC, Cheng YL, Su WL, et al. Co-existing obstructive sleep apnea reduces Nuss surgery efficacy in pectus excavatum[J]. PLoS One, 2022, 17(11): e0277494.
18
Kim DY, Jeong JY. Penetrating lung injury during Nuss procedure for pectus excavatum[J]. J Cardiothorac Surg, 2020, 15(1): 184.
19
牟 玲,徐 冰,兰志勋. 经食道超声心动图监测用于Nuss手术中的临床研究[J]. 中南大学学报(医学版), 2015, 40(4): 410-414.
20
Dahlbacka SJM, Ilonen IK, Kauppi JT, et al. Aortic haemorrhage during late pectus bar removal[J]. Eur J Cardiothorac Surg, 2020, 57(1): 191-192.
21
Maagaard M, Heiberg J. Improved cardiac function and exercise capacity following correction of pectus excavatum: a review of current literature[J]. Ann Cardiothorac Surg, 2016, 5(5): 485-492.
22
王 洁,何 龙,田丹丹,等. 漏斗胸患者Nuss手术后慢性疼痛的危险因素[J]. 临床麻醉学杂志2021, 37(2): 138-141.
[1] 缪黄泰, 李潇颖, 张明, 聂绍平. 急性心肌梗死后心脏破裂患者院内死亡的危险因素分析[J]. 中华危重症医学杂志(电子版), 2023, 16(03): 187-192.
[2] 李瑶悦, 马俊梅, 蒋琴, 陈芃螈, 侯昉, 徐冰, 刘文英. Nuss手术后钢板移位的原因分析与预防及处理[J]. 中华妇幼临床医学杂志(电子版), 2024, 20(02): 224-230.
[3] 麦苏德·马合木提, 丹尼尔·多里坤, 张海平, 张力为, 伊地力斯·阿吾提. 胸腔镜辅助微创手术(改良型Nuss术)矫正治疗小儿漏斗胸的临床疗效[J]. 中华妇幼临床医学杂志(电子版), 2022, 18(02): 228-233.
[4] 王磊, 蒋连勇, 徐佩, 毕锐, 胡睿, 谢晓, 刘洪涛, 肖海波, 胡丰庆. 复合式胸壁畸形的联合微创手术治疗[J]. 中华胸部外科电子杂志, 2023, 10(03): 143-148.
[5] 李好, 朱智军, 王磊, 胡丰庆, 李国庆, 王明松. 成人复发型漏斗胸的免翻转改良Nuss微创手术治疗[J]. 中华胸部外科电子杂志, 2023, 10(03): 131-136.
[6] 张波, 张峰, 邓仪宝, 贺旺平. 改良胸腔镜Nuss手术治疗青少年漏斗胸的临床研究[J]. 中华卫生应急电子杂志, 2019, 05(03): 147-151.
阅读次数
全文


摘要