236例中青年单侧自发性气胸患者同期双侧微创手术治疗的临床分析  

The Clinical Analysis of Hameochronous Bilateral Minimally Invasive Surgery for 236 Cases of Young and Middle-aged Unilateral Spontaneous Pneumothorax Patient

作　　者：刘胜中[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：《医学信息》2013年第2期192-193,共2页Journal of Medical Information

基　　金：四川省卫生厅科研课题（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2010年1月～2012年6月，我科对236例中青年单侧自发性气胸患g-经腋下小切口或电视胸腔镜同期行双侧肺大疱切除和胸膜固定手术治疗，并对其临床资料进行回顾性分析.结果术中发现所有患者双侧肺叶均存在肺大疱，且大部分对称存在。手术时间（992±41．5）min，术中失血量（30．8±15．5）ml；术后保留胸引管时间（32±1．51d，术后住院时间（4．5±3．0）d。全组无死亡病例，2例0．8％出现并发症，均治愈出院。术后随访178例（75.4％），随访（18．4±66）个月，1例（0.4％）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；同期行双侧肺大疙切除和胸膜固定术．能有效地治愈气胸，并能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 hameochronous bilateral minimally invasive surgery for young and middle-aged unilateral spontaneous pneumothorax patient. Methods The clinical data about 236 cases of young and middle-aged unilateral spontaneous pneumothorax patient underwent hameochronous bilateral pulmonary bulla resection and pleurodesis by limited axillary thoracotomy or video-assisted thoraeoscopy from January 2010 to June 2012 was retrospectively analysed. Results Pulmonary bulla was found in bilateral lung lobe of all patients. For most patients, pulmonary bulla distributed in bilateral lung lobe symmetrically. The operation time was mean （99.2±41.5） minutes. The quantity of blood loss during operation was mean （30.8±15.5） milliliters. The duration of chest tube drainage was mean （3.2±1.5） days, and the postoperative hospital stay was mean （4.5±3.0） days. No death happened, and only 2 patients ocemTed complications. All patients were cured and discharged. During the （18.4±6.6） months follow-up period, 1 of 178 patients recurred pneumothorax. Conclusion Symmetrical pulmonary bulla usually locates in bilateral lung lobe of young and middle-aged unilateral spontaneous pneumothorax patient, mainly in apicale segmentum of superior lobe. Hameochronous bilateral pulmonary bulla resection and pleurodesis by limited axillary thoracotomy or video-assisted thoracoseopy can cure pneumothorax, prevent pneumothorax recurring in operative side and pneumothorax occmTing in heterolateral side effectively. The security is high and the curative effect is exact. It should be extended in clinic.

关 键 词：自发性气胸 中青年 同期 双侧肺大疱切除术 微创手术 

分 类 号：R561.4[医药卫生—呼吸系统]