胸腔镜及其辅助手术与常规手术治疗高龄自发性气胸的对比研究  

Treatment of Aged Spontaneous Pneumothorax with Video Assisted Thoracoscope Surgery (VATS),VATS Assisted Small Incision Surgery and Thoracotomy

作　　者：张爱平[1] 陈鑫[1] 郑琳[1] 石开虎[1] 徐明[1] 赵海鹏[1] 刘培生[1] 王睿[1] 

机构地区：[1]南京医科大学附属南京第一医院心胸外科,江苏南京210006

出　　处：《中国内镜杂志》2008年第9期910-912,916,共4页China Journal of Endoscopy

摘　　要：目的探讨电视胸腔镜手术(Video-assisted thoracoscop ic surgery,VATS)及其辅助小切口手术与常规开胸手术治疗高龄自发性气胸的疗效,找到一种更适合高龄自发性气胸的手术治疗方法。方法45例高龄自发性气胸患者分别采用VATS手术、VATS辅助小切口手术和常规开胸手术治疗,比较其围术期治疗效果、肺功能变化及血清细胞因子IL-1和TNF-α变化。结果该组无死亡病例,均治愈出院。腔镜组较传统开胸术后胸引管留置时间及镇痛剂使用时间短,术中出血量少,出院早,差别有统计学意义(P<0.05),而腔镜组组间比较差别无统计学意义(P>0.05),腔镜组患者术后2周肺功能恢复较传统开胸组快(P<0.05),而腔镜组组间比较差别无统计学意义(P>0.05),术后2dIL-1和TNF-α开胸手术组较腔镜组显著升高(P<0.05),而腔镜组组间比较差别无统计学意义(P>0.05),同时手术时间VATS辅助小切口组介于传统开胸手术及VATS手术之间(P<0.05)。结论VATS辅助小切口手术,适合有合并症的老年自发性气胸患者,对心肺功能差者尤其适用。[Objective] To discuss the treatment efficiency of thoracoscope surgery (VATS), VATS assisted small incision surgery (VATS+SIS) and thoracotomy (TS) on spontaneous pneumothorax of aged patients, and to find out the most reasonable surgical method for the disease. [Method] 45 patients with aged spontaneous pneumothorax were randomly assigned to receive VATS, VATS+SIS, TS, which were defined as groups A, B and C respectively. The perioperative treatment efficiency, pulmonary function and serum levels of IL-1 ...

关 键 词：高龄 自发性气胸 电视胸腔镜辅助手术 

分 类 号：R655[医药卫生—外科学]