儿童胸骨裂外科矫治4例报道

目的 总结外科矫治儿童胸骨裂的临床经验。 方法 2006年12月至2012年10月手术治疗胸骨裂4例,男性2例,女性2例。病例1及病例2为Cantrell五联症,病例3及病例4为单纯性胸骨上裂。病例1及病例2均存在心脏异位,均修补胸骨下裂、腹壁缺损、膈肌缺损及膈面心包缺损。病例1合并小型室间隔缺损未处理,病例2合并肺动脉高压型右室双出口同期矫治。病例1及病例2采用斜行肋软骨切开术延长肋骨后对合胸骨,病例1辅以2根肋骨移植于胸骨下端。病例3采用向下完全切开胸骨,做成胸骨全裂后缝合胸骨。病例4为新生儿,采用向下楔形切除部分胸骨后向正中聚拢胸骨。结果 全组患儿手术矫形顺利,心肺无明显受压表现。随访8...

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Bibliographic Details
Published in复旦学报（医学版） Vol. 41; no. 3; pp. 365 - 368
Main Author 陶麒麟 贾兵 陈张根 叶明 陈纲
Format Journal Article
LanguageChinese
Published 复旦大学附属儿科医院心胸外科 上海201102 2014
Subjects
Cantrell五联症
儿童
手术
胸骨裂
sternal cleft
胸骨裂
children
Cantrell五联症
手术
pentalogy of Cantrell
儿童
surgery
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ISSN1672-8467
DOI10.3969/j.issn.1672-8467.2014.03.016

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Summary:目的 总结外科矫治儿童胸骨裂的临床经验。 方法 2006年12月至2012年10月手术治疗胸骨裂4例,男性2例,女性2例。病例1及病例2为Cantrell五联症,病例3及病例4为单纯性胸骨上裂。病例1及病例2均存在心脏异位,均修补胸骨下裂、腹壁缺损、膈肌缺损及膈面心包缺损。病例1合并小型室间隔缺损未处理,病例2合并肺动脉高压型右室双出口同期矫治。病例1及病例2采用斜行肋软骨切开术延长肋骨后对合胸骨,病例1辅以2根肋骨移植于胸骨下端。病例3采用向下完全切开胸骨,做成胸骨全裂后缝合胸骨。病例4为新生儿,采用向下楔形切除部分胸骨后向正中聚拢胸骨。结果 全组患儿手术矫形顺利,心肺无明显受压表现。随访8个月-6年,胸壁外观、心肺功能及生活状态满意。 结论 胸骨裂手术时机的把握和手术方法的选择与患儿的年龄、病变范围以及合并畸形密切相关。针对患儿的不同情况制定个体化治疗策略,可以达到满意的治疗效果。
Bibliography:TAO Qi-lin, JIA Bing, CHEN Zhang-gen, YE Ming, CHEN Gang（Department of Cardiothoracic Surgery,Children′s Hospital,Fudan University,Shanghai 201102,China）
sternal cleft;pentalogy of Cantrell; children; surgery
Objective To summarize the clinical experience of surgical correction on children with sternal cleft.Methods From Dec.,2006 to Oct.,2012,4 children （2 male,2 female）with sternal cleft who underwent surgical correction were reviewed retrospectively.Case 1 and case 2 who suffered from thoracicabdominal ectopia cordis were diagnosed as pentalogy of Cantrell.Case 3 and case 4 were diagnosed as asymptomatic superior sternal cleft.We repaired the defects in the anterior diaphragm,lower sternum,abdominal wall and diaphragmatic pericardium of case 1 and case 2.Intracardiac anomalies of the 2 patients included one case with a small membranous ventricular septal defect which was not required for surgical correction and another case with double outlet right ventricle which had one-stage repair.Case 1 and case 2 got
ISSN:1672-8467
DOI:10.3969/j.issn.1672-8467.2014.03.016