两孔与三孔电视胸腔镜手术治疗自发性气胸的临床分析  

Clinical analysis of two-port versus standard three-port video-assisted thoracoscopic surgery technique for spontaneous pneumothorax

作　　者：杨世疆[1] 平伟[1] 付向宁[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院胸外科,武汉430030

出　　处：《临床外科杂志》2013年第5期366-368,共3页Journal of Clinical Surgery

摘　　要：目的 分析比较传统三孔电视胸腔镜手术（三孔VATS）与两孔即单操作孔电视胸腔镜手术（两孔VATS）治疗原发性自发性气胸（PSP）的疗效.方法 85例PSP患者,随机分为三孔法组（43例）和两孔法组（42例）进行手术,两孔法组操作孔位于腋前线第3～4肋间,切口长1.5～2cm,疗效评价指标包括手术时间、胸腔引流量、平均住院时间,出院后气胸复发、术后疼痛发生情况.结果 85例患者均完成手术,顺利出院.1例两孔组患者中转为三孔VATS,两组在手术时间、胸腔引流量、平均住院时间,出院后气胸复发、术后疼痛发生情况比较差异无统计学意义（P〉0.05）.结论 两孔VATS治疗PSP安全可行,在取得与三孔VATS相同的疗效同时可减少手术创伤,体现了微创手术的优点.Objective To compare the curative effect and application scope between modified two-port video-assisted thoracoscopic surgery（VATS） and standard three-port VATS technique for the treatment of primary spontaneous pneumothorax（PSP）. Methods From February 2010 to June 2011 ,a total of 85 patients with PSP were divided into the three-port group （ n = 43）and the two-port group（ n = 42）. The operative port of the VATS was located in the anterior axillary line at the level of intercostal space between the 3rd and 4th rib. The incision ranged from 1.5 to 2.0 cm. The operation time, average postoperative thoracic drain volume, average hospital stay, statement of postoperative pain and recurrence were compared between the groups. Results All patients were operated and discharged successfully. One patient in the twoport group was transferred to the three-port VATS. There were no statistical differences in operation time, average postoperative thoracic drain volume, average hospital stay, statement of postoperative pain and re- current between two groups（P 〉 0.05）. Conclusion The two-port VATS is both safe and accessible in the treatment of PSP. It is as effective as the standard three-port VATS while minimizing the trauma and revealing the advantages of minimally invasive surgery. The two-port VATS is helpful and worth spreading in the treatment of thoracic disease with simple intrathoracic operation.

关 键 词：电视胸腔镜 两孔法 气胸 

分 类 号：R654[医药卫生—外科学]