漏斗胸之矯正方法及其對肺功能的影響

10.6666/ClinMed.202005_85(5).0051

林逸翰；洪榮志

漏斗胸（pectus excavatum） ； 胸廓畸型（chest wall deformity） ； Haller指數（Haller index） ； 肺功能（pulmonary function）

臨床醫學月刊

85卷5期（2020 / 05 / 29）

276 - 279

繁體中文

漏斗胸（pectus excavatum）為最常見的胸廓畸型疾病，發生率大約為兩百分之一，以男性病患為多。此類患者因肋軟骨的不正常增生而導致疼痛、胸廓凹陷及心臟或肺臟壓迫。外觀的缺損及心肺功能不佳常造成患者的同儕壓力，也是病患最常見的主訴。漏斗胸的矯正方法，主要有Ravitch及Nuss治療法兩種。Ravitch治療法包括將病患的增生肋軟骨切除及胸骨復位；Nuss治療法則是使用矯正鋼板將病患的胸廓復位。兩種手術法對於漏斗胸的外觀矯正均有著優異的治療成效。漏斗胸患者的術前肺功能檢查多無明顯的異常，跟病患的運動耐受性不佳之主訴並不符合。然而在經手術矯正後，儘管肺功能檢查並無明顯的變化，甚至因傷口疼痛而造成肺功能減少，患者卻多主訴獲得運動能力的顯著改善。因此雖然漏斗胸患者矯正後之肺功能改善與否存在著爭議，病患術後外觀獲得改善，並且主觀上大多自覺有運動能力的改善。

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