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中华胸部外科电子杂志 ›› 2023, Vol. 10 ›› Issue (02) : 70 -79. doi: 10.3877/cma.j.issn.2095-8773.2023.02.03

胸壁创伤和畸形矫治专题

罕见胸廓畸形的手术治疗
王文林()   
  1. 510317 广州,广东省第二人民医院胸壁外科研究院
  • 收稿日期:2022-12-02 修回日期:2023-04-20 接受日期:2023-04-26 出版日期:2023-05-28
  • 通信作者: 王文林

Surgical treatment of rare thoracic deformity

Wenlin Wang()   

  1. Institute of Chest Wall Surgery, Guangdong Second Provincial General Hospital, Guangzhou 510317, China
  • Received:2022-12-02 Revised:2023-04-20 Accepted:2023-04-26 Published:2023-05-28
  • Corresponding author: Wenlin Wang
引用本文:

王文林. 罕见胸廓畸形的手术治疗[J]. 中华胸部外科电子杂志, 2023, 10(02): 70-79.

Wenlin Wang. Surgical treatment of rare thoracic deformity[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2023, 10(02): 70-79.

除了漏斗胸、鸡胸、扁平胸和桶状胸等常见的胸廓畸形,临床上尚有其他罕见的胸廓畸形,由于其发病率低,很少有医生关注。胸壁外科的理念出现后,胸廓畸形被当作胸壁外科主要的手术内容,各种罕见畸形因此得到重视,进而推动了此类畸形诊断和治疗工作的开展。本文对临床上罕见胸廓畸形的手术治疗状况进行综述。

In addition to the common thoracic deformities (pectus excavatum, pectus carinatum, flat chest and barrel chest), there are other rare thoracic deformities. Because of the low incidence rate, few doctors have paid attention to them. With the appearance of the conception of chest wall surgery, of which thoracic deformity has been regarded as the main operation content, various rare deformities have been noticed by surgeons, and thus promoting the development of diagnosis and treatment of such deformities. This article reviews the status of surgical treatment of rare thoracic deformities in clinical practice.

图1 Poland综合征。A:男性患者胸壁;B:合并的并指畸形;C:女性患者胸壁
图2 胸廓发育不良综合征。A:前胸壁外观;B:背部外观;C,D:胸廓三维重建图像显示一侧肋骨融合
图3 窒息性胸廓发育不良(Jeune综合征)。A:Ⅰ型患者的胸壁外观;B:Ⅱ型患者的胸壁外观;C,D:影像学检查显示侧胸壁凹陷,肺部明显受压
图4 Wang手术示意图。A,B,C:用于一般凹陷畸形治疗的经典Wang手术;D,E,F:用于窒息性胸廓发育不良治疗的Wang手术
图5 Wenlin手术示意图。A:钢板与胸廓畸形的形状;B:手术效果图
图6 沟状胸。A:前胸壁正面图;B:前胸壁侧面图
图7 鞍状胸。A:前胸壁侧面图;B:前胸壁正面图
图8 Wenlin胸。A:前胸壁正面图;B:前胸壁侧面图
图9 锐角畸形(箭头示)。A:前胸壁凹陷一侧边缘为锐角畸形;B,C:影像学检查显示锐角畸形位于凹陷一侧边缘和凹陷底部
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