手术医生应用膨肺机自控膨肺在自发性气胸胸腔镜手术中的应用  

The Application of Lung Inflating Device by the Surgeon in Video-assisted Thoracoscopic Surgery for Spontaneous Pneumothorax

作　　者：龚立宏[1] 姚达[1] 王萍[1] 万延辉[1] 罗伟彬[1] 吴国栋[1] 

机构地区：[1]深圳市第二人民医院胸外科,深圳518029

出　　处：《中国微创外科杂志》2014年第3期256-258,261,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：深圳市科技创新委基金项目(JCYJ20130401114745072)

摘　　要：目的探讨胸外科医生自控膨肺的方法。方法2012年1月-2013年3月，在胸腔镜手术治疗25例自发性气胸病人过程中，手术医生使用膨肺机自控膨肺探查肺上病灶，确定切除范围及术侧胸腔排气。结果25例均顺利完成手术，24例完全胸腔镜下手术，1例胸腔镜辅助小切口手术。每例膨肺2～7次，平均3．6次。每次膨肺时间5—10s。胸腔排气所需时间30～45s。无术后肺部感染。随访6～21个月，平均14个月，术侧无气胸复发。结论自控膨肺是现代化的膨肺模式，具有手术医生膨肺自主、膨肺状态可控、操作快捷等优点，值得进一步研究推广。Objective To explore a novel method for lung inflation handled by the surgeon himself during thoracic operation. Methods In the treatment of 25 patients of spontaneous pneumothorax during video-assisted thoracoscopie surgery （VATS） from January 2012 to March 2013, the surgeon handled lung inflation device to inflate the lung for detecting lesions, determining the extent of surgical resection and exhausting the air from the pleura cavity at the end of the surgery. Results All the 25 cases went through the surgery successfully, including 24 cases of total thoracoscopie surgery and one case of video-assisted minithoracotomy （ VAMT）. The lung was inflated 2 to 7 times （ average, 3.6 times） in each case and the time of lung inflation was 5 - 10 s every time. The time required to exhaust the air from the pleura cavity was 30 - 45 s. No postoperative pulmonary infection occurred. During the follow-up of 6 to 21 months （average, 14 months） , no recurrence of pneumothorax near the operative site was found. Conclusions The lung inflation device handled by the surgeon to inflate the lung is a modern mode in which the surgeon can independently complete lung inflation during the operation without the help of anesthetist and accurately control the inflation of the lung. The novel method is efficient and safe in exhausting the air from the chest and is worthy of further research and promotion.

关 键 词：膨肺 单肺通气 自发性气胸 电视胸腔镜手术 

分 类 号：R655[医药卫生—外科学] R561.4[医药卫生—临床医学]