电视胸腔镜的临床应用研究  

The clinical application research of video-assisted thoracic surgery

作　　者：李玮[1] 

机构地区：[1]济宁市第二人民医院,山东济宁272067

出　　处：《济宁医学院学报》2012年第4期239-242,共4页Journal of Jining Medical University

摘　　要：目的探讨电视胸腔镜手术(VATS)治疗胸部外科疾病的临床应用与疗效分析。方法 1998年3月至2012年5月,开展VATS手术734例,包括自发性气胸195例,肺大疱142例,肺部良性疾病94例,纵隔肿瘤22例,食管平滑肌瘤4例,食管癌11例,心包囊肿10例,肺癌14例,胸外伤中血气胸行胸腔内探查92例,肺裂口修补术38例,凝固性血胸清除术64例,创伤性膈疝修补4例,外伤性连枷胸44例。结果 614例经胸腔镜完成手术,96例附加胸部小切口(VAMT),24例中转开胸手术;胸部手术时间为20～180min,平均56min;术后住院5～33d,平均9d;所有患者无围手术期死亡和严重并发症发生,术后临床症状明显改善,疗效满意。结论 VATS治疗胸部外科疾病较传统开胸手术具有安全可靠、有效、微创和恢复快及术后并发症少等优点,适时附加胸部小切口,积极防治并发症,可使VATS更安全,应用范围更加广泛。Objective To study the clinical application and curative effect of Video-Assisted Thoracic Surgery（VATS）.Methods 734 cases were performed with VATS from March,1998 to May,2012,including 195 cases of spontaneous pneumothorax,142 cases of Bullae of lung,94 cases of Pulmonary benign diseases,22 cases of Mediastinal tumor,4 cases of Esophageal leiomyoma,11 cases of Esophageal cancer,10 cases of Pericardial cyst,14 cases of Lung cancer,92 cases of Chest trauma and hemopneumothorax thoracic exploration,38 cases of Pulmonary fissure repair,64 cases of Removal of coagulated hemothorax,4 cases of Traumatic diaphragmatic hernia and 44 cases of Traumatic flail chest.Results 614 cases of operations were carried out through VATS,96 cases through VAMT,24 cases were transferred to Thoracic surgery.The operations take 20~180 minutes,56 minutes on average.Postoperative hospitalization was 5~23 days after operation,9 days on average.No perioperative death and serious complications occurred and clinical improvement was observed in all the patients.Conclusion Compared with traditional thoracic surgery,VATS is safer,more reliable,more effective,less invasive,recover sooner,and lower risk of postoperative complications.Timely additional chest incision could prevent and treat complications,and make VATS more secure broader range of applications.

关 键 词：电视胸腔镜术 胸部疾病 微创 

分 类 号：R655[医药卫生—外科学]