外伤后积留血胸患者经胸腔镜手术26例临床分析  

Role of video-assisted thoracoscopy in management of retained posttraumatic hemothorax in 26 cases

作　　者：李叙[1] 栗兰凯[1] 魏小东[1] 昌其[1] 康建宏[1] 王志华[1] 

机构地区：[1]解放军第101医院胸外科,江苏无锡214044

出　　处：《中国内镜杂志》2009年第12期1318-1319,1322,共3页China Journal of Endoscopy

摘　　要：目的总结经电视胸腔镜手术(VATS)治疗外伤后积留血胸的临床应用。方法回顾分析该院3年来经VATS治疗外伤后积留血胸患者的临床资料。结果26例积留血胸患者,术前有19例患者行胸腔闭式引流术,且9例行第2次胸腔闭式引流术。有21例行经VATS胸腔积液清除术。5例因胸腔粘连明显,行VATS辅助小切口胸腔积液清除术。经VATS手术胸腔积液清除术患者伤后至手术平均时间为16.5d,平均清除积液730mL,术后平均2.8d拔除胸腔闭式引流管。患者恢复良好,无并发症及死亡。结论VATS对胸部创伤后积留血胸患者的治疗具有创伤小、恢复快的优点,是安全、有效的方法。[ Objective ] To determine the role of video-assisted thoracoscopy （VATS） in the management of retained posttraumatic hemothorax. [Methods] The clinical data of 26 patients with retained hemothorax who underwent VATS between August 2005 and September 2008 were reviewed. [Results] Of the 26 cases, 19 had closed thoracic drainage, and 9 had two attempts before VATS. In 21 patients pleural effusion was successfully evacuated by VATS. In 5 patients pleural effusion was evacuated by video-assisted mini-incision thoracotomy because of dense pleural adhesion. The mean time interval between injury and VATS was 16.5 days （range： 4 days- 2 months）. The mean evacuated volume of pleural fluid by thoracoscopy was 730 mL. The average postoperative tube stay was 2.8 days. There was neither complication nor death. [Conclusion] VATS is an effective, safe operative therapy for retained posttraumatic hemothorax because of its minimal invasion and quick recovery.

关 键 词：电视胸腔镜手术 积留血胸 

分 类 号：R561.5[医药卫生—呼吸系统]