同期双侧微创手术治疗中青年单侧自发性气胸628例分析  

Analysis of 628 young and middle-aged patients with unilateral spontaneous pneumothorax treated with minimally invasive operation bilateral simultaneously

作　　者：刘胜中[1] 曾富春[1] 薛洋[1] 丛伟[1] 

机构地区：[1]四川省医学科学院.四川省人民医院心胸外科,四川成都610072

出　　处：《实用医院临床杂志》2013年第1期134-136,共3页Practical Journal of Clinical Medicine

基　　金：四川省卫生厅科研基金资助项目(编号:100529)

摘　　要：目的探讨中青年单侧自发性气胸患者同期行双侧微创手术治疗的可行性、安全性及有效性。方法对2003年3月至2011年12月在我科接受同期双侧微创手术治疗的628例中青年单侧自发性气胸患者的临床资料进行回顾性分析。结果所有患者双侧均存在肺大疱,且大部分对称存在。全组手术时间(101.4±47.8)min,术中失血量(31.5±19.3)ml;术后保留胸引管时间(3.5±1.4)d,术后住院时间(4.5±3.5)d。术后随访432例,随访(35.7±10.1)个月,2例复发气胸。结论中青年单侧自发性气胸患者往往双侧肺叶都有相对称的肺大疱病变存在,主要位于上叶尖段,同期行双侧肺大疱切除术,能有效地预防气胸复发和对侧发作气胸,安全性高,疗效确切。Objective To investigate the feasibility, security and effectiveness of simultaneous bilateral minimally invasive operations for young and middle-aged patients with unilateral spontaneous pneumothorax. Methods Six hundred and twenty-eight young and middle-aged patients with unilateral spontaneous pneumothorax from March 2003 to December 2011 were involved in this study. These patients underwent simultaneous bilateral minimally invasive surgery. The clinical data of were retrospectively analyzed. Results Pulmonary bulla was found in bilateral lung lobes of all patients. The pulmonary bullas were symmetrically distributed in bilateral lung lobes in the most cases. The mean operation time was（ 101.4 ± 47.8 ） minutes. The average blood loss during operation was（ 31.5 ± 19. 3 ） milliliters. The postoperative retained chest tube time was （ 3.5 ± 1.4 ） days, and the postoperative hospital stay was （ 4. 5 ± 3.5 ） days. Four hundred and thirty-two of 628 patients were followed-up for（ 35.7 ± 10. 1 ） months, and two patients were found to have relapse pneumothorax. Conclusion The young and middle-aged patients with unilateral spontaneous pneumothorax always have symmetrical pulmonary bullas ,which were usually located at the apical segment of upper lobe. Simultaneous resection of bilateral pulmonary bulla by minimally invasive surgery is not only effectively to prevent pneumothorax recurrence in the operative side, but also pneumothorax in the contra lateral side. The treatment approach has high security and curative effectiveness.

关 键 词：自发性气胸 微创手术 肺大疱切除术 

分 类 号：R561.4[医药卫生—呼吸系统] R655[医药卫生—内科学]