管状奈维垫片在胸腔镜下手术治疗中重度肺气肿自发性气胸中的应用价值  

Efficiency of bulla resection with Endo Gia auto suture padded with tube type Neoveil pad in management of spontaneous pneumothorax with emphysema under video-assisted thoracoscopic surgery

作　　者：滕洪[1] 王述民[1] 曲家骐[1] 侯维平[1] 高昕[1] 

机构地区：[1]沈阳军区总医院胸外科,辽宁沈阳110016

出　　处：《临床军医杂志》2014年第12期1235-1237,1290,共4页Clinical Journal of Medical Officers

摘　　要：目的探讨胸腔镜辅助小切口直线切创缝合器加管状奈维垫片切除肺大疱治疗中重度肺气肿自发性气胸的效果和术中术后注意事项。方法2009年9月一2013年12月采用胸腔镜辅助小切口直线切剖缝合器加管状奈维垫片方法（VATSN）切除肺大疱治疗中重度肺气肿自发性气胸15例，并与胸腔镜常规直线切害IJ器切除或切除缝合（VATS）方法31例比较。结果VATSN切除15例。其中肺大疱切除10例，肺减容5例。手术时间30～85（50±8．2）rain，出血35～130（40±29．5）ml。术后带管时间6～35（9．7±5．7）d，术后住院时间8～37（10．9±6．1）d，与VATS组31例术后带管和住院时间比较明显减少（P〈0．01）。术后持续漏气超过15d2例，带管时间分别为15和35d，术后漏气发生率（13．33％）小于VATS组（22．58％），但差异无统计学意义（P〉0．05）。无其他并发症，无死亡。随访〈1年5例，1～2年6例，≥3年4例。无复发。结论VATSN方法切除肺气肿肺大疱操作简单，安全确切。能够明显减少术后肺泡漏气，明显缩短术后带胸引管时间，减少并发症发生，为中、重度肺气肿自发性气胸比较理想的手术方法。Objective To evaluate the method of bulla resection with Endo Gia auto suture padded with tube type Neoveil pad to management of spontaneous pneumothorax with emphysema under video-assisted thoracoscopic surgery （VATS） and its efficiency. Methods Fifteen patients with spontaneous neumothorx with emphysema underwent bulla resection with Endo Gia auto suture pad- ded with tube type Neoveil pad under VATS from Sept. 2009 to Dec. 2013, and were enrolled in trial group. Another 31 patients with the same disease who underwent bulla resection with Eudo Gia auto suture under VATS were enrolled in control group. Results In the trial group, bulla resection was performed in 10 and lung volume reduction in 5 patients. The operation time for unilateral side was 30 - 85 rain with an average of 50 ＋ 8.2 rain. The bleeding volume was 35 - 130 ml with an average of 40 ±29.5 ml. The time of postoperative chest tube drainage was 6 -35 （9.7±5.7） d. The postoperative hospital-stay was 8 -37 （10.9 ± 6.1 ） d. The time of postoperative chest tube drainage or postoperative hospital-stay was significantly shorter than that of the control group （ P 〈 0.01 ）. There were 2 patients with chest tube leak over 15 days, with a rate of 13.33% , lower than that （22.58%） in the control group （P 〉 0.05）. Conclusion Bulla resection with Endo Gia auto suture padded with tube type Neoveil pad in management of spontaneous pneumothorax with emphysema under VATS is a safe and effective procedure in management of spontaneous pneumotho- rax with emphysema.

关 键 词：肺气肿 自发性气胸 胸腔镜手术治疗 奈维垫片 

分 类 号：R563.3[医药卫生—呼吸系统]