1) The reasons for these two malformations are:
1. Congenital dysplasia-during the fetal or infant period, the development of sternum, spine and ribs is unbalanced, resulting in chest deformity.
2. Malnutrition-infants and young children do not get enough nutrition after birth, and suffer from some malnourished diseases, such as rickets in children, which will affect the development of sternum for a long time and cause thoracic deformity.
3. Diseases secondary to the chest-such as some congenital heart diseases, the enlarged heart compresses the chest wall, forming a chicken breast deformity. Flat chest deformity caused by chronic empyema.
2) The harm of these two malformations.
Generally, mild thoracic deformity has little effect on human physiological function, so preventive measures should be taken to prevent it from continuing to develop. For example, chest deformity is more serious, especially funnel chest. The heart and lungs in the chest are compressed to varying degrees, and even the heart is displaced, and the pulmonary ventilation function is also affected. If it develops further, it is easy to have serious diseases such as respiratory tract infection.
3) Diagnosis and treatment of these two malformations:
1. The diagnosis of funnel chest and chicken breast should pass the chest examination. In order to determine whether there are indications for surgical treatment, necessary chest X-ray examination and determination of heart and brain function should also be carried out. Cases of pectus excavatum and chicken breast complicated with severe cardiopulmonary dysfunction are rare. Children with slight deformities can be corrected with age and physical development. This situation does not need special treatment, and can be observed after 3-5 years old, and attention should be paid to the prevention and treatment of primary rickets.
2. For children with severe deformity, especially funnel chest complicated with severe cardiopulmonary dysfunction, surgical treatment should be given. This kind of operation should be treated by experienced doctors in specialized hospitals.
4) Treatment of pectus excavatum
Traditional treatment: foreign operations to correct pectus excavatum began in the 1970s, and China also carried out such operations in the 1980s. In 1990s, pediatric surgery gradually matured. In the past, the conventional treatment of funnel chest was to cut a window of about 10 cm in the longitudinal and transverse direction of the chest, and then cut off the deformed ribs and fix them with steel needles. Surgical trauma, bleeding. Moreover, because the integrity of the child's chest is destroyed, the lung function is seriously affected in a short time, which will lead to bronchial obstruction and atelectasis leading to severe hypoxia.
In addition, after the operation, the operation will fail because the corrected chest cavity is not fixed, and the spontaneous breathing movement affects the bone growth. The perioperative management of this operation is difficult, risky and complicated. Traditional treatment methods at home and abroad mostly adopt steel needle sternum elevation, which is not ideal. At present, the improved operation adopts double steel plate sternum elevation method, which obviously improves the operation level and has good effect. In fact, the effect of surgery depends on the level of medical equipment, such as ventilator, monitor, lung function monitoring means and so on. With the continuous development of medical technology and the improvement of advanced medical equipment and personnel training level, the complications of this kind of operation have been obviously reduced, but there are still some risks and complications in infant surgery.
5) Current treatment method
At present, the most advanced thoracoscopic assisted pectus excavatum correction in China-
The method is to cut a small incision of 2 cm in the middle line of the lower thoracic axil of the child, peel it off with thoracoscope and guide it, then insert the self-made correction device into the opposite side and turn it over, so as to achieve the purpose of correction. The surgical incision is about 1.5-20 cm long, so it is necessary to remove the diseased costal cartilage and do sternal osteotomy. Surgical trauma, bleeding, postoperative pain in children, slow recovery. No matter what kind of surgery, the risk of hypoxic brain damage, lung infection and atelectasis still exists due to the destruction of chest integrity by cutting off ribs.
6) A new pectus excavatum operation without thoracotomy.
At present, there are doctors who treat pectus excavatum without thoracotomy: only two small incisions of 2 cm are made in the child's chest wall, and steel plates are placed behind the patient's sternum after shaping according to the patient's chest, and both ends of the steel plates are supported on the patient's ribs to correct the child's pectus excavatum deformity. The new operation without thoracotomy has the advantages of less trauma and less bleeding. Intraoperative steel plate can be shaped according to the degree of thoracic deformity of patients, which is more suitable for individual differences and has better surgical effect. Postoperative patients have little pain, can get out of bed the next day, and the hospitalization time is short and the hospitalization cost is low, which is a good method to treat funnel chest in modern times.
7) The operation adapts to the age
Pectus excavatum belongs to congenital skeletal dysplasia, not caused by calcium deficiency and malnutrition, and its etiology is still unclear.
In 1970s, the youngest patient of this kind of operation abroad was about 4-5 years old. At present, the best operation age depends on the hospital conditions and the level of surgeons. Experts believe that according to the characteristics of children's bones, the best time to correct funnel chest is 2-4 years old. Surgery at a young age cannot affect children's development. At present, there have been 1-3-year-old children who have done this kind of operation, and most of them have achieved good results.
8) Non-surgical treatment of chicken breast
1. Stand with your feet shoulder width, relax, close your eyes slightly, lift your arms forward to the top of your head gently, inhale at the same time, pause for a moment, let your arms droop naturally, accompanied by deep exhalation, several times a day, each time 10 minute.
2. Push-ups or lifting dumbbells to do double-arm lifting exercises, 3-4 times a day, each time 10 minute.
Turn the tendons on the parallel bars on an empty stomach every morning, but don't be too tired.
4. Jogging helps to enhance visceral activity, increase respiratory ability and improve thoracic dysplasia.
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