漏斗胸
胸凹陷（英语：Pectus excavatum）是一种前胸廓壁的胸骨和胸腔向内凹陷的一类先天畸形，中文将这种胸凹陷的畸形称为漏斗胸（英语：Funnel Chest）。这一畸形使得胸部向下形成漏斗状内陷，影响正常的心血管和呼吸系统功能，患者在胸腔和背部会伴有痛感。这一先天性疾病既可能在出生时发病，也可能在青春期之后才逐渐出现，对患者可能产生严重的心理负担，使其尽可能避免一切有可能暴露该畸形的活动。[1]
| 漏斗胸 | |
|---|---|
| 又称 | 胸凹陷 |
 | |
| 一例极度严重的漏斗胸 | |
| 类型 | bone development disease[*]、deformity of chest and rib[*]、遗传性疾病、医学征象[*] |
| 分类和外部资源 | |
| 医学专科 | 骨外科 |
| ICD-10 | Q67.6 |
| ICD-9-CM | 754.81 |
| OMIM | 169300 |
| DiseasesDB | 29401 |
| MedlinePlus | 003320 |
| eMedicine | 1004953 |
| MeSH | D005660 |
征兆和症状
编辑
胸骨内塌陷为本病决定特征。最常见的为胸板下端的杯状内陷，但也存在上肋软骨塌陷造成的较大的胸内陷。[2]最下端的肋骨可能凸起，（英语中称为"flared ribs"）。[3] 胸内陷既可能是对称分布的，也可能是非对称分布的。患者会伴前胸或后背疼痛，痛觉通常源于骨骼肌系统。[4]
温和病例中，心血管呼吸功能不受到影响，但伴心脏异位、旋转或二者兼具。[5]严重病例中，右心房受到压迫，诱发二尖瓣脱垂（即在心脏中单向摆动、控制血流的二尖瓣叶在心室收缩期脱入左心房），肺功能因为肺容量减少而受到限制。[6][7]疾病常伴尴尬感、羞耻感、社交焦虑在内的心理压力，导致患者与外人的活动和交流减少，情绪负面化、极端化，失望情绪浓重，以致于产生重度抑郁症。[8]
参见
编辑参考资料
编辑- ^ Pectus excavatum. MedLine Plus Medical Encyclopedia. 美国国家医学图书馆 and the 国立卫生研究院 (美国). 2007-11-12 [2018-12-14]. （原始内容存档于2016-07-05）.
- ^ Blanco FC, Elliott ST, Sandler AD. Management of congenital chest wall deformities. Seminars in Plastic Surgery (Review). 2011, 25 (1): 107–16. PMC 3140238
. PMID 22294949. doi:10.1055/s-0031-1275177.
- ^ See for example Bosgraaf RP, Aronson DC. Treatment of flaring of the costal arch after the minimally invasive pectus excavatum repair (Nuss procedure) in children. Journal of Pediatric Surgery. 2010, 45 (9): 1904–6. PMID 20850643. doi:10.1016/j.jpedsurg.2010.05.037.
- ^ Pectus Excavatum Clinical Presentation: History. Medscape. 30 June 2015 [7 September 2016]. （原始内容存档于2021-01-19）.
- ^ Fokin AA, Steuerwald NM, Ahrens WA, Allen KE. Anatomical, histologic, and genetic characteristics of congenital chest wall deformities. Seminars in Thoracic and Cardiovascular Surgery (Review). 2009, 21 (1): 44–57. PMID 19632563. doi:10.1053/j.semtcvs.2009.03.001.
- ^ Cardiopulmonary Manifestations of Pectus Excavatum. Medscape. （原始内容存档于2017-04-18）.
- ^ Jaroszewski, Dawn E.; Warsame, Tahlil A.; Chandrasekaran, Krishnaswamy; Chaliki, Hari. Right Ventricular Compression Observed in Echocardiography from Pectus Excavatum Deformity. Journal of Cardiovascular Ultrasound. December 2011, 19 (4): 192–195. ISSN 1975-4612. PMC 3259543 . PMID 22259662. doi:10.4250/jcu.2011.19.4.192.
- ^ Brandon, Mike. Orthopedic approach to pectus deformities: 32 years of studies. Pectus Excavatum Info. Pediatric Orthopedist and Physiatrist, Orthopectus Clinical Center and Asa Norte Regional Hospital. 2Doctor in Orthopedics, School of Medicine, University de Sāo Paulo, Ribeirāo Preto, SP. Pediatric Orthopedist, Orthopectus Clinical Center. Preceptor, Adult Foot and Pediatric Orthopedics, Federal District Hospital, Brasilia, DF. 2016-02-04 [2016-02-04]. （原始内容存档于2016-05-08）.
拓展阅读
编辑- Tocchioni F, Ghionzoli M, Messineo A, Romagnoli P. Pectus excavatum and heritable disorders of the connective tissue. Pediatric Reports (Review). 2013, 5 (3): e15. PMC 3812532 . PMID 24198927. doi:10.4081/pr.2013.e15.
- Jaroszewski D, Notrica D, McMahon L, Steidley DE, Deschamps C. Current management of pectus excavatum: a review and update of therapy and treatment recommendations. Journal of the American Board of Family Medicine : JABFM (Review). 2010, 23 (2): 230–9 [2018-12-14]. PMID 20207934. doi:10.3122/jabfm.2010.02.090234. （原始内容存档于2014-06-07）.
