中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

漏斗胸 SDP 三维分类法

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目的 介绍一种漏斗胸分类方法。 方法 回顾性 2015 年 1 月至 2017 年 9 月间的 569 例漏斗胸手术患者的临床资料,从左右对称性(symmetry,简写 S)、前后深度(depth,简写 D)和上下位置(position,简写 P)三个维度对畸形进行描述并分类,根据畸形指标的权重计算最终积分,以此评估畸形的严重程度。所有患者均接受 NUSS 手术或者改良 NUSS 手术。 结果 漏斗胸畸形被分为 24 种类型,最多见的类型为 S1D2P1,占全部病例的 27.2%;其次是 S1D2P2、S1D1P2、S2D2P2 三种类型,分别占全部病例的 12.0%、11.6%、11.4%。在我们的病人中,没有发现 S1D3P3、S1D3P4、S2D3P3 三种类型。根据权重积分,321 例为轻度患者,23 例为重度患者,其余为中度患者。术后所有患者胸廓外观均得到改善,其中植入一条钢板者 405 例,两条钢板者 159,三条钢板者 5 例,住院天数 5~12(7.3±1.5)d。 结论 此分类方法是一种较为全面的分类法,但其科学性、实用性尚需进一步证实。

Objective To introduce a novel classification method for pectus excavatum. Methods A retrospective review of 569 operative patients with pectus excavatum between January 2015 and September 2017 was performed. The malformations were described and classified from three dimensions: symmetry (abbreviated S), depth (abbreviated D) and position (abbreviated P). The final integral was calculated according to the deformity index, so that the severity of the deformity could be evaluated. All patients underwent NUSS or modified NUSS surgery. Results All pectus excavatum deformities are classified into 24 types. The most common type is S1D2P1, accounting for 27.2% of the total cases; followed by S1D2P2, S1D1P2 and S2D2P2 three types, accounting for 12%, 11.6% and 11.4% of all cases respectively. Three types of S1D3P3, S1D3P4, and S2D3P3 were not found in our patients. According to the integral, 321 cases were mild, 23 cases were severe, and the rest were moderate. The appearance of all patients was improved after the operation. Among them, 405 cases were implanted with a plate, 159 cases were implanted with two plates, and 5 cases were implanted with three plates. The length of stay was 5~12 days, with an average of (7.3 + 1.5) days. Conclusion This classification method is a more comprehensive classification, but its scientific and practical characteristics need to be further confirmed.

关键词: 漏斗胸; SDP 分类法; 三维

Key words: Pectus excavatum; SDP classification method; three dimensional

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