漏斗胸
胸凹陷（英語：Pectus excavatum）是一種前胸廓壁的胸骨和胸腔向內凹陷的一類先天畸形，中文將這種胸凹陷的畸形稱為漏斗胸（英語：Funnel Chest）。這一畸形使得胸部向下形成漏斗狀內陷，影響正常的心血管和呼吸系統功能，患者在胸腔和背部會伴有痛感。這一先天性疾病既可能在出生時發病，也可能在青春期之後才逐漸出現，對患者可能產生嚴重的心理負擔，使其儘可能避免一切有可能暴露該畸形的活動。[1]
| 漏斗胸 | |
|---|---|
| 又稱 | 胸凹陷 |
 | |
| 一例極度嚴重的漏斗胸 | |
| 類型 | bone development disease[*]、deformity of chest and rib[*]、遺傳性疾病、醫學徵象[*] |
| 分類和外部資源 | |
| 醫學專科 | 骨外科 |
| ICD-10 | Q67.6 |
| ICD-9-CM | 754.81 |
| OMIM | 169300 |
| DiseasesDB | 29401 |
| MedlinePlus | 003320 |
| eMedicine | 1004953 |
| MeSH | D005660 |
徵兆和症狀
編輯
胸骨內塌陷為本病決定特徵。最常見的為胸板下端的杯狀內陷，但也存在上肋軟骨塌陷造成的較大的胸內陷。[2]最下端的肋骨可能凸起，（英語中稱為"flared ribs"）。[3] 胸內陷既可能是對稱分布的，也可能是非對稱分布的。患者會伴前胸或後背疼痛，痛覺通常源於骨骼肌系統。[4]
溫和病例中，心血管呼吸功能不受到影響，但伴心臟異位、旋轉或二者兼具。[5]嚴重病例中，右心房受到壓迫，誘發二尖瓣脫垂（即在心臟中單向擺動、控制血流的二尖瓣葉在心室收縮期脫入左心房），肺功能因為肺容量減少而受到限制。[6][7]疾病常伴尷尬感、羞恥感、社交焦慮在內的心理壓力，導致患者與外人的活動和交流減少，情緒負面化、極端化，失望情緒濃重，以致於產生重度抑鬱症。[8]
參見
編輯參考資料
編輯- ^ Pectus excavatum. MedLine Plus Medical Encyclopedia. 美國國家醫學圖書館 and the 國立衛生研究院 (美國). 2007-11-12 [2018-12-14]. （原始內容存檔於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]. （原始內容存檔於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. （原始內容存檔於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]. （原始內容存檔於2016-05-08）.
拓展閱讀
編輯- 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. （原始內容存檔於2014-06-07）.
