单操作孔胸腔镜手术治疗自发性气胸的操作方法和临床应用价值  

Analysis of single operating methods of operation and the clinical value of the hole thoracoscopic surgery for spontaneous pneumothorax

作　　者：曹亮[1] 王树军[1] 刘金山[1] 张道忠[1] 

机构地区：[1]安徽省淮南新华医院胸外科,安徽淮南232052

出　　处：《临床和实验医学杂志》2015年第15期1283-1286,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的探讨单操作孔胸腔镜手术治疗肺大疱的操作方法和临床应用价值。方法将51例自发性气胸患者按照治疗方式分为开胸组(n=24)与胸腔镜组(n=27),分别采用传统开胸术与单操作孔胸腔镜手术进行治疗。比较两组手术相关指标水平、手术前后血气指标水平及术后并发症发生率。结果 1胸腔镜组手术时间、术中出血量、术后引流量、术后住院时间、术后疼痛评分及术后拔管时间均显著小于开胸组(P<0.05)。2两组术后Pa O2水平均显著高于术前(P<0.05,P<0.01),两组术后Pa CO2水平均显著低于术前(P<0.05,P<0.01),且胸腔镜组术后Pa O2及Pa CO2水平变化较开胸组更明显,差异均具有统计学意义(P<0.05)。3胸腔镜组术后继发感染、皮下气肿及局部渗液发生率均显著小于开胸组(P<0.05)。结论与传统开胸手术相比,单操作孔胸腔镜手术治疗自发性气胸的疗效显著,具有较高的临床应用价值。Objective To investigate the clinical applications of the method of operation single operation thoracoscopic surgery for spontaneous pneumothorax hole. Methods 51 cases of patients with spontaneous pneumothorax were randomly divided into open chest group（ n = 24）and thoracoscopic group（ n = 27） according to the pattern of treatment,respectively,using the traditional thoracotomy and thoracoscopic surgery operation hole single treatment. Surgery- related indicators were compared,including blood gas levels,incidence of postoperative complications and before and after surgery. Results ① The operative time,blood loss,postoperative drainage,postoperative hospital stay,postoperative pain scores and postoperative extubation time of thoracoscopic group were significantly lower than the open chest group（ P〈0. 05）. ② The PaO2 of two postoperative were significantly higher than before surgery（ P〈0. 05,P〈0. 01）,postoperative PaO2 was significantly lower than the preoperative（ P〈0. 05,P〈0. 01）,and postoperative PaO2 and PaCO2 level differences were statistically significant（ P〈0. 05）. ③Subcutaneous emphysema and local effusion occurred in the thoracoscopic group after secondary infection were significantly lower than the open chest group（ P〈0. 05）. Conclusion Compared with traditional thoracotomy,the efficacy of single operation hole thoracoscopic surgery for spontaneous pneumothorax significantly,with a high clinical value.

关 键 词：自发性气胸 单操作控胸腔镜手术 开胸手术 

分 类 号：R655[医药卫生—外科学]