VATS在膈疝外科治疗中的实施与疗效评价  

作　　者：肖东[1] 何建行[1] 韦兵[1] 殷伟强[1] 

机构地区：[1]广州医学院第一附属医院胸外科,510120

出　　处：《广州医药》2008年第3期18-20,共3页Guangzhou Medical Journal

摘　　要：目的探讨VATS在膈疝外科治疗中的应用与疗效。方法收集2005年12月-2007年12月确诊为膈疝并行VATS膈疝回纳＋膈肌修补术治疗的17例患者的临床资料。回顾性分析手术入路、切口选择、手术时间、术中失血、术后引流时间和引流量等情况。结果体位、入路同常规VATS手术，在患侧锁骨中线处行一2cm小切口，另于患侧腋前线第6肋、第7肋间各行一2cm小切口进行手术。全组手术时间为（45—120）min，平均74．7min；切口为1.0—4．0cm，平均2．15cm；术中失血5—20ml，平均10．9ml；术后均放置胸管1条，引流1—3天，平均1．47天；总引流量15—170ml，平均107．17ml；术中术后未见明显并发症。平均术后住院时间为1—5天，平均2．47天。结论膈疝的VATS外科治疗是可行的、安全的、有效的、微创的，具有广阔的发展前景，但还需要更多病例的进一步评估。Objective Approach the useing and the therapeutic effective of VATS in the diaphragmatic hernia surgery. Methods 1 case who diagnosed the right diaphragmatic hernia by CT, a 59 years old female, we use the way of VATS fight diaphragmatic hernia retroposition ＋ diaphramatic muscle prosthesis. We analyze and arrange the date of operative approach, selection of the incision, time of operation, blood lose in the operation, time and flow of postoperative drainage and so on. Resalts Adopt the right or left dorsal position pad up about 30°, make a 1 cm incision at the midclavicular line, the 8 intercostal. Also, make two 1 cm incisions at the right or left anterior axillary line, at the 6 and 10 intercostal for the operation. The operation time is between 45 - 120mins （mean 41.45 mins） . The incision is 1.5 -4 cm （mean 2. 15 cm） . Intraoperative bleeding is 5 - 20 ml （ mean 10. 9 ml） . Postoperative chest tube drainage placed 1-3 days （ mean 1.47 days）, 1 tube, whole drainage volume is 15 - 170 ml （ mean 107.17 ml） . Length of postoperative hospital stay is 1 - 25 days （ mean 6. 97 days） . No obviously complications in or after the operation. The patient discharge 7 days after the operation. No preoperative symptoms. Conclusion Use VATS to cure the diaphragmatic hernia is avalilable, safe, effective less wound. This way has a wide perspective, but we need more cases to evaluate the effect.

关 键 词：膈疝 电视辅助胸腔镜手术 疗效 

分 类 号：R655[医药卫生—外科学] R735.7[医药卫生—临床医学]