• 中國醫(yī)學(xué)科學(xué)院北京協(xié)和醫(yī)學(xué)院整形外科醫(yī)院乳房整形與再造中心（北京，100144）;

目的對(duì)近年先天性漏斗胸的治療進(jìn)展作一綜述。 方法廣泛查閱近年國內(nèi)外治療先天性漏斗胸的相關(guān)文獻(xiàn)，總結(jié)治療現(xiàn)狀及進(jìn)展。 結(jié)果先天性漏斗胸矯正方法主要有胸廓成形術(shù)（Ravitch胸骨抬高術(shù)和Nuss微創(chuàng)手術(shù)）和假體植入術(shù)，磁力推進(jìn)和無創(chuàng)負(fù)壓吸引治療尚處于研究階段。 結(jié)論先天性漏斗胸的矯正除改善功能外，對(duì)外觀要求也在提高，微創(chuàng)和無創(chuàng)治療是下一步研究重點(diǎn)。

引用本文： 吉愷,欒杰. 先天性漏斗胸的治療進(jìn)展. 中國修復(fù)重建外科雜志, 2012, 26(12): 1516-1518. doi: 復(fù)制

1. 19 Chang PY, Chang CH, Lai JY, et al. A method for the non-invasive assessment of chest wall growth in pectus excavatum patients. Eur J Pediatr Surg, 2010, 20(2): 82-84. 20 Haller JA Jr, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectus excavatum surgery: a prelminary report. J Pediatr Surg, 1987, 22(10): 904-906.
2. 21 Kuenzler KA, Stolar CJ. Surgical correction of pectus excavatum. Paediatr Respir Rev, 2009, 10(1): 7-11. 22 Nasr A, Fecteau A, Wales PW. Comparison of the Nuss and the Ravitch procedure for pectus excavatum repair: a meta-analysis. J Pediatr Surg, 2010, 45(5): 880-886. 23 曾騏, 張娜, 范茂槐, 等. Nuss手術(shù)與改良Ravitch手術(shù)的對(duì)比研究. 中華小兒外科雜志, 2005, 26(8): 397-399.
3. 27 Luu TD, Kogon BE, Force SD, et al. Surgery for recurrent pectus deformities. Ann Thorac Surg, 2009, 88(5): 1627-1631. 28 吉毅, 劉文英, 徐冰, 等. 非胸腔鏡輔助微創(chuàng)Nuss手術(shù)矯治復(fù)發(fā)漏斗胸. 中國修復(fù)重建外科雜志, 2008, 22(10): 1213-1217．.
4. 32 Harrison MR, Estefan-Ventura D, Fechter R, et al. Magnetic mini-mover procedure for pectus excavatum: I. Development, design, and simulations for feasibility and safety. J Pediatr Surg, 2007, 42(1): 81-85. 33 Harrison MR, Curran PF, Jamshidi R, et al. Magnetic mini-mover procedure for pectus excavatum II: initial findings of a Food and Drug Administration-sponsored trial. J Pediatr Surg, 2010, 45(1): 185-191. 34 Haecker FM, Mayr J. The vacuum bell for treatment of pectus excavatum: an alternative to surgical correction? Eur J Cardiothorac Surg, 2006, 29(4): 557-561.
5.
6.
7.
8.
9.
10.
11. 王煒. 整形外科學(xué). 杭州: 浙江科學(xué)技術(shù)出版社, 1999: 844-847.
12. Kelly R Jr. Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation. Semin Pediatr Surg, 2008, 17(3): 182-193.
13. Cartoski MJ, Nuss D, Goretsky MJ, et al. Classification of the dysmorphology of pectus excavatum. J Pediatr Surg, 2006, 41(9): 1573-1581.
14. Kelly RE Jr, Shamberger RC, Mellins RB, et al. Prospective multicenter study of surgical correction of pectus excavatum: design, perioperative complications, pain, and baseline pulmonary function facilitated by internet-based data collection. J Am Coll Surg, 2007, 205(2): 205-216.
15. Beier JP, Weber PG, Reingruber B, et al. Aesthetic and functional correction of female, asymmetric funnel chest—a combined approach. Breast, 2009, 18(1): 60-65.
16. Fonkalsrud EW. Current management of pectus excavatum. World J Surg, 2003, 27(5): 502-508.
17. Nakaoka T, Uemura S, Yano T, et al. Does overgrowth of costal cartilage cause pectus excavatum? A study on the lengths of ribs and costal cartilages in asymmetric patients. J Pediatr Surg, 2009, 44(7): 1333-1336.
18. Fonkalsrud E. Management of pectus chest deformities in female patients. Am J Surg, 2004, 187(2): 192-197.
19. Jaroszewski D, Notrica D, McMahon L, et al. Current management of pectus excavatum: a review and update of therapy and treatment recommendations. J Am Board Fam Med, 2010, 23(2): 230-239.
20. Laituri CA, Garey CL, St Peter SD. Review of the technical variants in the repair of pectus excavatum. Eur J Pediatr Surg, 2010, 20(4): 217-221.
21. 胡廷澤. 漏斗胸外科治療: 30年406例經(jīng)驗(yàn)回顧. 中華小兒外科雜志, 2005, 26(8): 393-395.
22. Snel BJ, Spronk CA, Werker PM, et al. Pectus excavatum reconstruction with silicone implants: long-term results and a review of the english-language literature. Ann Plast Surg, 2009, 62(2): 205-209.
23. Nuss D, Kelly RE Jr, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg, 1998, 33(4): 545-552.
24. Sørensen J. Subcutaneous silicone implants in pectus excavatum. Scand J Plast Surg, 1988, 22(2): 173-176.
25. Saour S, Shaaban H, McPhail J, et al. Customised silicone prostheses for the reconstruction of chest wall defects: technique of manufacture and final outcome. J Plast Reconstr Aesthet Surg, 2008, 61(10): 1205-1209.
26. Margulis A, Sela M, Neuman R, et al. Reconstruction of pectus excavatum with silicone implants. J Plast Reconstr Aesthet Surg, 2006, 59(10): 1082-1086.
27. Marks MW, Argenta LC, Lee DC. Silicone implant correction of pectus excavatum: indications and refinement in technique. Plast Reconstr Surg, 1984, 74(1): 52-58.
28. Moscona RA, Fodor L. How to perform breast augmentation safely for a pectus excavatum patient. Aesthetic Plast Surg, 2011, 35(2): 198-202.
29. Park HJ, Lee SY, Lee CS, et al. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients. Ann Thorac Surg, 2004, 77(1): 289-295.
30. 曾騏, 張娜, 陳誠豪, 等. 漏斗胸的分型和微創(chuàng)Nuss手術(shù). 中華外科雜志, 2008, 46(15): 1160-1162.
31. 梁海龍, 劉吉福, 趙京, 等. Nuss手術(shù)矯正成年人漏斗胸22例臨床分析. 臨床軍醫(yī)雜志, 2011, 39(1): 76-78.
32. Hosie S, Sitkiewicz T, Petersen C, et al. Minimally invasive repair of pectus excavatum—the Nuss procedure. A European multicentre experience. Eur J Pediatr Surg, 2002, 12(4): 235-238.
33. Fang FC, Cheng YL, Lee SC, et al. Clinical experience of Nuss procedure for pectus excavatum in adult female patients. Thorac Cardiovasc Surg, 2008, 56(5): 283-286.
34. Rapuzzi G, Torre M, Romanini MV, et al. The nuss procedure after breast augmentation for female pectus excavatum. Aesthetic Plast Surg, 2010, 34(3): 397-400.
35. Haecker FM. The vacuum bell for conservative treatment of pectus excavatum: the Basle experience. Pediatr Surg Int, 2011, 27(6): 623-627.
  1. 1. 19 Chang PY, Chang CH, Lai JY, et al. A method for the non-invasive assessment of chest wall growth in pectus excavatum patients. Eur J Pediatr Surg, 2010, 20(2): 82-84. 20 Haller JA Jr, Kramer SS, Lietman SA. Use of CT scans in selection of patients for pectus excavatum surgery: a prelminary report. J Pediatr Surg, 1987, 22(10): 904-906.
  2. 2. 21 Kuenzler KA, Stolar CJ. Surgical correction of pectus excavatum. Paediatr Respir Rev, 2009, 10(1): 7-11. 22 Nasr A, Fecteau A, Wales PW. Comparison of the Nuss and the Ravitch procedure for pectus excavatum repair: a meta-analysis. J Pediatr Surg, 2010, 45(5): 880-886. 23 曾騏, 張娜, 范茂槐, 等. Nuss手術(shù)與改良Ravitch手術(shù)的對(duì)比研究. 中華小兒外科雜志, 2005, 26(8): 397-399.
  3. 3. 27 Luu TD, Kogon BE, Force SD, et al. Surgery for recurrent pectus deformities. Ann Thorac Surg, 2009, 88(5): 1627-1631. 28 吉毅, 劉文英, 徐冰, 等. 非胸腔鏡輔助微創(chuàng)Nuss手術(shù)矯治復(fù)發(fā)漏斗胸. 中國修復(fù)重建外科雜志, 2008, 22(10): 1213-1217．.
  4. 4. 32 Harrison MR, Estefan-Ventura D, Fechter R, et al. Magnetic mini-mover procedure for pectus excavatum: I. Development, design, and simulations for feasibility and safety. J Pediatr Surg, 2007, 42(1): 81-85. 33 Harrison MR, Curran PF, Jamshidi R, et al. Magnetic mini-mover procedure for pectus excavatum II: initial findings of a Food and Drug Administration-sponsored trial. J Pediatr Surg, 2010, 45(1): 185-191. 34 Haecker FM, Mayr J. The vacuum bell for treatment of pectus excavatum: an alternative to surgical correction? Eur J Cardiothorac Surg, 2006, 29(4): 557-561.
  5. 5.
  6. 6.
  7. 7.
  8. 8.
  9. 9.
  10. 10.
  11. 11. 王煒. 整形外科學(xué). 杭州: 浙江科學(xué)技術(shù)出版社, 1999: 844-847.
  12. 12. Kelly R Jr. Pectus excavatum: historical background, clinical picture, preoperative evaluation and criteria for operation. Semin Pediatr Surg, 2008, 17(3): 182-193.
  13. 13. Cartoski MJ, Nuss D, Goretsky MJ, et al. Classification of the dysmorphology of pectus excavatum. J Pediatr Surg, 2006, 41(9): 1573-1581.
  14. 14. Kelly RE Jr, Shamberger RC, Mellins RB, et al. Prospective multicenter study of surgical correction of pectus excavatum: design, perioperative complications, pain, and baseline pulmonary function facilitated by internet-based data collection. J Am Coll Surg, 2007, 205(2): 205-216.
  15. 15. Beier JP, Weber PG, Reingruber B, et al. Aesthetic and functional correction of female, asymmetric funnel chest—a combined approach. Breast, 2009, 18(1): 60-65.
  16. 16. Fonkalsrud EW. Current management of pectus excavatum. World J Surg, 2003, 27(5): 502-508.
  17. 17. Nakaoka T, Uemura S, Yano T, et al. Does overgrowth of costal cartilage cause pectus excavatum? A study on the lengths of ribs and costal cartilages in asymmetric patients. J Pediatr Surg, 2009, 44(7): 1333-1336.
  18. 18. Fonkalsrud E. Management of pectus chest deformities in female patients. Am J Surg, 2004, 187(2): 192-197.
  19. 19. Jaroszewski D, Notrica D, McMahon L, et al. Current management of pectus excavatum: a review and update of therapy and treatment recommendations. J Am Board Fam Med, 2010, 23(2): 230-239.
  20. 20. Laituri CA, Garey CL, St Peter SD. Review of the technical variants in the repair of pectus excavatum. Eur J Pediatr Surg, 2010, 20(4): 217-221.
  21. 21. 胡廷澤. 漏斗胸外科治療: 30年406例經(jīng)驗(yàn)回顧. 中華小兒外科雜志, 2005, 26(8): 393-395.
  22. 22. Snel BJ, Spronk CA, Werker PM, et al. Pectus excavatum reconstruction with silicone implants: long-term results and a review of the english-language literature. Ann Plast Surg, 2009, 62(2): 205-209.
  23. 23. Nuss D, Kelly RE Jr, Croitoru DP, et al. A 10-year review of a minimally invasive technique for the correction of pectus excavatum. J Pediatr Surg, 1998, 33(4): 545-552.
  24. 24. Sørensen J. Subcutaneous silicone implants in pectus excavatum. Scand J Plast Surg, 1988, 22(2): 173-176.
  25. 25. Saour S, Shaaban H, McPhail J, et al. Customised silicone prostheses for the reconstruction of chest wall defects: technique of manufacture and final outcome. J Plast Reconstr Aesthet Surg, 2008, 61(10): 1205-1209.
  26. 26. Margulis A, Sela M, Neuman R, et al. Reconstruction of pectus excavatum with silicone implants. J Plast Reconstr Aesthet Surg, 2006, 59(10): 1082-1086.
  27. 27. Marks MW, Argenta LC, Lee DC. Silicone implant correction of pectus excavatum: indications and refinement in technique. Plast Reconstr Surg, 1984, 74(1): 52-58.
  28. 28. Moscona RA, Fodor L. How to perform breast augmentation safely for a pectus excavatum patient. Aesthetic Plast Surg, 2011, 35(2): 198-202.
  29. 29. Park HJ, Lee SY, Lee CS, et al. The Nuss procedure for pectus excavatum: evolution of techniques and early results on 322 patients. Ann Thorac Surg, 2004, 77(1): 289-295.
  30. 30. 曾騏, 張娜, 陳誠豪, 等. 漏斗胸的分型和微創(chuàng)Nuss手術(shù). 中華外科雜志, 2008, 46(15): 1160-1162.
  31. 31. 梁海龍, 劉吉福, 趙京, 等. Nuss手術(shù)矯正成年人漏斗胸22例臨床分析. 臨床軍醫(yī)雜志, 2011, 39(1): 76-78.
  32. 32. Hosie S, Sitkiewicz T, Petersen C, et al. Minimally invasive repair of pectus excavatum—the Nuss procedure. A European multicentre experience. Eur J Pediatr Surg, 2002, 12(4): 235-238.
  33. 33. Fang FC, Cheng YL, Lee SC, et al. Clinical experience of Nuss procedure for pectus excavatum in adult female patients. Thorac Cardiovasc Surg, 2008, 56(5): 283-286.
  34. 34. Rapuzzi G, Torre M, Romanini MV, et al. The nuss procedure after breast augmentation for female pectus excavatum. Aesthetic Plast Surg, 2010, 34(3): 397-400.
  35. 35. Haecker FM. The vacuum bell for conservative treatment of pectus excavatum: the Basle experience. Pediatr Surg Int, 2011, 27(6): 623-627.