漏斗胸的術前評估：針對納氏手術(Nuss Procedure)的軟體開發及臨床之應用

漏斗胸是胸壁最常見的先天性畸型。漏斗胸的患者在外觀上呈現前胸壁向內凹陷情形，使胸腔空間變小，並且壓迫到心臟及肺臟，而心肺的功能受到影響。漏斗胸的矯治不僅只是外觀的整復，更重要的是心肺功能的增進，在兒童期早期矯治，可以得到最好的效果。漏斗胸的手術方法，傳統治療漏斗胸必須進行大傷口的手術；自1998年Dr. Nuss首先發表他的納氏手術(Nuss procedure)，顯示此種手術的優越性及可接受性。這種手術標榜的是簡單、迅速，手術過程中會將一條不鏽鋼矯正板由腋下植入而置放於胸骨後方，利用此矯正鋼板將內凹之胸骨向外推出來做矯正手術。這種微創的納氏手術要把這內凹的前胸往外恢復到甚程度，並沒有一定的標...

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Published in台灣醫學 Vol. 15; no. 1; pp. 1 - 7
Main Authors 鄭裕仁(Yu-Jen Cheng), 宋文旭(Wen-Hsu Sung), 黃明賢(Ming-Shyang Huang), 楊明泉(Ming-Chan Yang), 張籐瀝(Teng-Li Chang), 謝坤洲(Kun-Chou Hsieh), 張博智(Po-Chih Chang), 王剛弘(Kang-Hung Wan)
Format Journal Article
LanguageChinese
Published 台灣 臺灣醫學會 25.01.2011
Subjects
Nuss prodecure
Pectus excavatm
Software
TSCI
漏斗胸
納氏手術
軟體
納氏手術
Nuss prodecure
軟體
software
Pectus excavatm
漏斗胸
Online AccessGet full text
ISSN1028-1916
DOI10.6320/FJM.2011.15(1).01

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Abstract 漏斗胸是胸壁最常見的先天性畸型。漏斗胸的患者在外觀上呈現前胸壁向內凹陷情形，使胸腔空間變小，並且壓迫到心臟及肺臟，而心肺的功能受到影響。漏斗胸的矯治不僅只是外觀的整復，更重要的是心肺功能的增進，在兒童期早期矯治，可以得到最好的效果。漏斗胸的手術方法，傳統治療漏斗胸必須進行大傷口的手術；自1998年Dr. Nuss首先發表他的納氏手術(Nuss procedure)，顯示此種手術的優越性及可接受性。這種手術標榜的是簡單、迅速，手術過程中會將一條不鏽鋼矯正板由腋下植入而置放於胸骨後方，利用此矯正鋼板將內凹之胸骨向外推出來做矯正手術。這種微創的納氏手術要把這內凹的前胸往外恢復到甚程度，並沒有一定的標準，只能靠手術醫師術中的模擬及即興創作。本研究之目的主要針對漏斗胸的病人，透過病患的胸部電腦斷層檢查影像，重建出其有缺陷的胸型外觀，再以自創的數位模型塑型軟體，編修出理想的胸型，取得手術矯正板的外型，作為進行真實手術時的參考。此一方法可在術前模擬出病人接受胸部矯正板矯正後的胸形，在病人未接受開刀前即可和病人及其家屬直接在電腦影像上，討論大家可接受的胸型，增加手術結果的可接受性及減少醫療糾紛。此計畫發展過程中接受96年國科會小產學計畫(NSC96-2622-B-214-001-CC3; EDP J96015)，及義大醫院98年院內計畫(EDAH-P98021)補助開發此一軟體且取得臨床數據。
AbstractList Pectus excavatum is an unbalanced growth in the costochondral regions resulting in depression deformity of the anterior chest wall. The surgical indications of such deformity are the physiologic and the psychological (cosmetic) effects. The minimal invasive Nuss procedure is the operation most adapted in recent years with the advantage of less invasion, short operation time and simple method. This procedure utilized a stainless Pectus bar, which is shaped as needed and put into the thoracic cavity, to push outward the depressed sternum. The main limitation of this procedure is that the operated surgeon makes the shape of the Pectus bar subjectively during the operation. If the chest wall deformity is complex or the experience of the surgeon is limited, it is then difficult for a surgeon to shape the Pectus bar satisfactorily. Therefore, it is our design that we can develop a computer-software to imitate the post-operative chest wall contour based on the pre-operative chest computer tomography of the patient.
漏斗胸是胸壁最常見的先天性畸型。漏斗胸的患者在外觀上呈現前胸壁向內凹陷情形，使胸腔空間變小，並且壓迫到心臟及肺臟，而心肺的功能受到影響。漏斗胸的矯治不僅只是外觀的整復，更重要的是心肺功能的增進，在兒童期早期矯治，可以得到最好的效果。漏斗胸的手術方法，傳統治療漏斗胸必須進行大傷口的手術；自1998年Dr. Nuss首先發表他的納氏手術(Nuss procedure)，顯示此種手術的優越性及可接受性。這種手術標榜的是簡單、迅速，手術過程中會將一條不鏽鋼矯正板由腋下植入而置放於胸骨後方，利用此矯正鋼板將內凹之胸骨向外推出來做矯正手術。這種微創的納氏手術要把這內凹的前胸往外恢復到甚程度，並沒有一定的標準，只能靠手術醫師術中的模擬及即興創作。本研究之目的主要針對漏斗胸的病人，透過病患的胸部電腦斷層檢查影像，重建出其有缺陷的胸型外觀，再以自創的數位模型塑型軟體，編修出理想的胸型，取得手術矯正板的外型，作為進行真實手術時的參考。此一方法可在術前模擬出病人接受胸部矯正板矯正後的胸形，在病人未接受開刀前即可和病人及其家屬直接在電腦影像上，討論大家可接受的胸型，增加手術結果的可接受性及減少醫療糾紛。此計畫發展過程中接受96年國科會小產學計畫(NSC96-2622-B-214-001-CC3; EDP J96015)，及義大醫院98年院內計畫(EDAH-P98021)補助開發此一軟體且取得臨床數據。
Author 鄭裕仁(Yu-Jen Cheng)
黃明賢(Ming-Shyang Huang)
謝坤洲(Kun-Chou Hsieh)
王剛弘(Kang-Hung Wan)
宋文旭(Wen-Hsu Sung)
楊明泉(Ming-Chan Yang)
張籐瀝(Teng-Li Chang)
張博智(Po-Chih Chang)
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Keywords 納氏手術
Nuss prodecure
軟體
software
Pectus excavatm
漏斗胸
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Snippet 漏斗胸是胸壁最常見的先天性畸型。漏斗胸的患者在外觀上呈現前胸壁向內凹陷情形，使胸腔空間變小，並且壓迫到心臟及肺臟，而心肺的功能受到影響。漏斗胸的矯治不僅只是外觀...
Pectus excavatum is an unbalanced growth in the costochondral regions resulting in depression deformity of the anterior chest wall. The surgical indications of...
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SubjectTerms Nuss prodecure
Pectus excavatm
Software
TSCI
漏斗胸
納氏手術
軟體
Title 漏斗胸的術前評估：針對納氏手術(Nuss Procedure)的軟體開發及臨床之應用
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