重症自发性气胸的外科治疗(附48例报道)  

Surgical strategies for severe spontaneous pneumothorax

作　　者：孙顺兴[1] 崔超[1] 李强[1] 

机构地区：[1]天津市海河医院胸外科,天津300350

出　　处：《中国内镜杂志》2008年第6期589-591,共3页China Journal of Endoscopy

摘　　要：目的总结重症自发性气胸外科治疗的经验与效果。方法从以下几方面回顾性总结该院1995～2005年48例重症自发性气胸手术病例的临床资料:重症自发性气胸的临床与X线特点;重症自发性气胸的手术指征;手术方法的选择。结果48例开胸手术取前外侧切口14例,后外侧切口18例,腋下小切口10例,电视胸腔镜(VATS)6例。手术证实自发性气胸由肺大疱所致42例(87.5%),继发于肺结核4例(8.3%),胸腔内粘连带撕裂2例(4.2%)。行单纯大疱结扎14例,大疱切开缝合20例,肺楔形切除6例,肺叶切除2例。术后早期死亡1例,死亡率2%。经1～5年随访,复发1例,对侧气胸1例,其余病例均恢复良好。肺大疱是重症自发性气胸的主要病因。常规手术切口、小切口与胸腔镜处理肺大疱各有优点。结论重症自发性气胸一旦确诊且无绝对禁忌证者应积极外科治疗,手术效果是满意的。腋下小切口较常规切口创伤小,恢复快,但要严格选择适应证,胸腔镜优于腋下小切口和常规切口,值得推荐。如胸腔粘连重,常规切口暴露好,操作方便,应作为首选。[Objective] To Sum up the methods and effects of surgical strategies for spontaneous pneumothorax.[Methods] 48 case with spontaneous pneumothorax, who were treated by thoracotomy from 1995 to 2005, were retrospectively summarized from several aspects as follows: clinic features, X-ray features and operation indications of severe spontaneous pneumothorax; and the choice of surgical methods. [Results] In the 48 case of thoracotomy, 14 case had anterior lateral incision, 18 had posterior lateral incision, 10 c...

关 键 词：重症自发性气胸 治疗方法 外科 

分 类 号：R655[医药卫生—外科学]