chicken breast
Introduction
Chicken breast introduction The sternum forward bulge is called chicken chest (pectus carinatum, chickenbreast). Chicken breast is a common thoracic deformity. It is generally considered to be related to heredity. Most people think that it is caused by excessive growth of ribs and costal cartilage. The sternum deformity is secondary to ribs. Malformation. About 6% to 22% of chest deformities, male: female is about 3:1. Clinically, according to their different anatomical shapes and surgical treatment methods, the chicken breast is divided into 3 types, namely, the kettle chest (keelchest), spherical pigeon breast. (pouterpigeonbreast) and unilateral chicken breast (lateralbreast). In the middle, severe deformity may have adverse effects on the physical and psychological development of the sick child and should be treated surgically. basic knowledge The proportion of illness: 0.003% - 0.008% Susceptible people: no specific population Mode of transmission: mother-to-child transmission Complications: funnel chest
Cause
Chicken breast cause
Genetic (25%):
The principle of chicken chest deformity is not yet clear. The chicken chest deformity is generally considered to be genetically related to the funnel chest deformity. Most people think that it is caused by excessive growth of ribs and costal cartilage. The sternum deformity is secondary to rib deformity. Some people think that it is related to the abnormal development of the diaphragmatic attachment. The anterior part of the diaphragm is underdeveloped. It is not attached to the xiphoid process and the rib arch. It is attached to the posterior rectus sheath and deep exhaled rib arch, but attached to Behind the rectus abdominis sheath, when inhaling deeply, the upper part of the rectus abdominis muscle is pulled inward, and the muscles in the lateral part of the overgrown diaphragm are contracted, so that the Hao's ditch is deepened, and the lower part of the sternum is moved forward without the support of the diaphragm, resulting in formation. Chicken breast deformity.
Repeated chronic respiratory infections (25%):
The principle of chicken chest deformity is still unclear. Some people think that chicken chest deformity is associated with repeated chronic respiratory infections. Long-term chronic respiratory infections reduce lung tissue compliance and reduce respiratory function. In order to meet the breathing needs, the diaphragm muscles strengthen and pull the Hao's ditch. The trap is gradually forming a chicken chest deformity.
Prevention
Chicken breast prevention
1, the mother should pay attention to nutrition in the end of pregnancy, eat more eggs, animal liver and other foods containing vitamin D and protein, often sun, and take vitamin D and calcium under the guidance of a doctor.
2, newborn babies should try to breastfeed, because vitamin D and other nutrients in breast milk are easy to absorb, 4 months when the baby begins to add complementary foods, do not mainly use cereals, otherwise it will affect the absorption of calcium in the diet, should gradually Add eggs, liver and other foods containing more vitamin D.
3, the sun is the most convenient and economical way to prevent rickets, the safest and most effective way, after the baby has passed the full moon, you can gradually increase the sun time, in normal weather, the sun can be used for 2 hours or so to meet the needs of vitamin D Avoid direct sunlight in the summer, play in the shade of the trees, do not wear glass or hats when you are in the sun, otherwise you will not be able to resist rickets.
4, taking medication on time is also an indispensable preventive measure, the baby should take vitamin D and calcium under the guidance of a doctor for half a month, and regularly go to the health care unit for health checkup.
Complication
Chicken chest complications Complications funnel chest
In patients with this disease, light chickens can be free of complications or clinical symptoms. In severe cases, the thoracic cage can be changed by the deformed sternum, and the heart and lungs can be squeezed, which can seriously affect the cardiopulmonary function, resulting in corresponding clinical symptoms. With complications such as Marfan syndrome and neurofibromatosis, respiratory complications such as repeated upper respiratory tract infections and bronchial wheezing often occur in patients with severe chicken thorax.
Symptom
Chicken breast symptoms common symptoms wheezing thoracic deformity
Chicken breast is a kind of deformity opposite to the funnel chest, and the sternum is convex forward. However, the chicken chest has a lower incidence than the funnel chest and the clinical symptoms are lighter. Therefore, it is not taken seriously by patients and their families. Most chicken breasts are not easy to be It is found that it is more obvious after the early childhood, the chicken chest is rarely erosive. The severe chicken breast often has repeated upper respiratory tract infection and asthma, poor endurance, fatigue, and more importantly, the patient is mentally deformed. There is a great burden, the incidence of chicken chest is lower than the funnel chest, the slight chicken breast often does not see the doctor, the heavier chicken chest deformity is obvious, it is easy to be diagnosed clinically, the lateral X-ray can clearly show the deformity of the sternum, other examinations The method often has no abnormal findings.
Most chicken breasts are not found in the same way as the funnel chest. They are often noticed after the age of five or six years old. Generally, the chicken chest rarely suffers from cardiopulmonary symptoms. Repeated upper respiratory tract infections and bronchial wheezing often occur in severe chicken breasts. Poor endurance, fatigue, and more importantly, the patient has a great mental burden due to deformity.
Clinically, according to the different forms of the sternum, the chicken breast can be divided into three types:
1, boat chest
Mainly for the sternum elongation, forward bulge, bilateral lower costal cartilage subsided, the shape of the ship's keel, severe cases reduce the chest volume, lateral framing on the ribs and sternum separation, sternal posterior space prolonged.
2, spherical pigeon chest
The spherical pigeon chest is characterized by the sternum stem, the sternal connection and the ridge cartilage of the adjacent costal cartilage. If the ple is angle is reduced, it will cause a depression of 2ö3 below the sternum, making the 2nd to 5th. The costal cartilage is raised next to the sternum, and the spherical pigeon is often accompanied by a sternal ossification line, especially the sternum and the early ossification of the sternum connection. It can be seen before the child is 3 years old or even 3 years old. In this case, 99% of the people, regardless of their age, their sternum and sternum joints are open [the ossification of the sternum and the joint of the sternum and the sternal bulge of the sternum, called the "sternal horn joint" ( Angu lated syno sto sis of the sternum ).
3, unilateral chicken breast
Unilateral chicken breast, also known as asymmetrical chicken breast, is characterized by one side of the chest wall, sometimes accompanied by a contralateral sagging. The costal cartilage deformity plays an important role in this type, and the sternal position is not obvious.
Examine
Chicken breast examination
(1) X-ray: The chest X-ray shows that the lower part of the sternum and the adjacent costal cartilage are obviously sunken, and the distance between the spine and the sternum is increased. X-ray of the spine to observe the presence or absence of lateral curvature of the spine.
(2) CT scan: CT scan can more accurately evaluate the extent, symmetry, heart and lung effects of chicken breast and other problems. Such as combined with cystic adenomatoid malformation, isolation of the lungs, sputum swelling and so on.
(3) Electrocardiogram: occasionally sinus arrhythmia, incomplete right bundle branch block.
(4) Heart and lung function tests: Cardiopulmonary function declines in extremely severe cases.
(5) Blood biochemistry: Some patients have mild anemia and elevated serum alkaline phosphatase.
Diagnosis
Chicken breast diagnosis
Differential diagnosis
It is sometimes necessary to identify chicken breasts and funnel chests clinically:
The chicken breast is opposite to the funnel chest, and the sternum protrudes forward. Generally, there are two types. The first one is common, and the keel has a keel-like thorax, that is, the lower part of the sternum is moved forward and sent to the upper part, which is often the most prominent part of the xiphoid attachment. Obviously, the longitudinal plane of the pectoral muscle is arched, and the 4 to 8 rib cartilage on both sides is deep and concave like a parallel to the sternum, making the protruding part more obvious, just like a giant hand grabbing the sternum and placing the sides The costal cartilage is compressed. Another kind of chicken breast is rare. The sternum stem, the upper part of the sternum and the upper part of the upper rib cartilage protrude upwards, while the middle part of the sternum is bent backwards. The lower part of the chest muscle is protruding forward, the vector of the sternum. The shape of the face is "Z" shaped, and the costal cartilage on both sides is also inwardly recessed, so some people also refer to such a deformity as a funnel chest.
Clinically, it is sometimes necessary to differentially diagnose different types of chicken breasts:
1, boat chest
Mainly for the sternum elongation, forward bulge, bilateral lower costal cartilage subsided, the shape of the ship's keel, severe cases reduce the chest volume, lateral framing on the ribs and sternum separation, sternal posterior space prolonged.
2, spherical pigeon chest
The spherical pigeon chest is characterized by the sternum stem, the sternal connection and the ridge cartilage of the adjacent costal cartilage. If the ple is angle is reduced, it will cause a depression of 2ö3 below the sternum, making the 2nd to 5th. The costal cartilage is raised next to the sternum, and the spherical pigeon is often accompanied by a sternal ossification line, especially the sternum and the early ossification of the sternum connection. It can be seen before the child is 3 years old or even 3 years old. In all cases, 99% of the people, regardless of age, their sternum stem, sternum connection is open, ossification of the sternum stem and body junction and sternal bulge, known as "sternal horny bone connection" (angu) Lone syno sto sis of the sternum ).
3, unilateral chicken breast
Unilateral chicken breast, also known as asymmetrical chicken breast, is characterized by one side of the chest wall, sometimes accompanied by a contralateral sagging. The costal cartilage deformity plays an important role in this type, and the sternal position is not obvious.
