腋下小切口行巨型肺大疱手术分析  

Giant bullae resection with small subaxillary incision

作　　者：余长永[1] 马海涛[1] 倪斌[1] 张勇[1] 

机构地区：[1]苏州大学附属第一医院心胸外科,江苏苏州215006

出　　处：《海南医学院学报》2010年第4期455-457,共3页Journal of Hainan Medical University

基　　金：海南医学院科研基金资助学报项目(0020100114)~~

摘　　要：目的:探讨腋下小切口行巨型肺大疱切除的外科手术方法、预后及应用价值。方法:回顾性分析我院心胸外科2003年6月～2009年3月50例巨型肺大疱患者经腋下小切口行手术治疗的资料。结果:50例患者中痊愈48例,治愈率96%。术后出现并发症16例(32%),包括肺部感染10例,其中行气管切开4例,死亡1例;另有5例术侧胸腔内持续漏气(>7d),1例为术后并发细支气管胸膜瘘,带胸管出院。同期行双侧胸腔手术2例,单侧分期手术8例。所有痊愈患者术后均有不同程度的呼吸困难缓解表现,术后随访6个月～6年,无一例复发。结论:采用腋下小切口手术治疗巨型肺大疱是理想的手术方式,具有创伤小,安全可行,疗效可靠,无需特殊或昂贵的微创设备等优点,在大多数医院中具有广阔的应用前景。Objective：To discuss the application and prognosis of giant bullae resection with subaxillary incision.Methods：Retrospectively analysed clinic data of 50 patients with giant emphysematous bullae treated with resection via small axillary incisions between June 2003 and March 2009.Results：Forty-eight of 50 cases were in cure with the cure rate as 96%.Sixteen patients（15%）had complication,including 5 cases with sustainable leakage in unilateral thoracic cavity more than 7 d,1 case with bronchiolus pleural fistule,and 10 cases with pulmonary infection,out of whom 4 cases had tracheotomy and 1 died.Two cases had bilateral chest surgery,and 8 cases had unilateral resection.All patients recovered with improvement of dyspnea to different extent.The follow-up for 6 months-6 years showed no recurrence.Conclusion：The axillary incision surgery is an ideal treatment for giant emphysematous bullae,with minimal invasion,safety and feasibility,reliable efficacy,and no needs for special or expensive equipments.It is valuable in clinic application.

关 键 词：巨型肺大疱 腋下小切口 外科手术 

分 类 号：R655[医药卫生—外科学]