单操作孔电视胸腔镜肺大疱切除术的临床应用  

Clinical experience and contrasitive analysis of single utility port video-assisted thoracoscopic surgery for pulmonary bullae resection

作　　者：李田[1] 梅新宇[1] 解明然[1] 吴显宁[1] 张天赐[1] 马冬春[1] 

机构地区：[1]安徽医科大学附属省立医院胸外科,合肥230001

出　　处：《安徽医科大学学报》2016年第5期699-702,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省卫生计生委中医药科研课题项目(编号:2014zy19)

摘　　要：目的探讨电视胸腔镜手术(VATS)单操作孔肺大疱切除的手术要点、临床应用价值及疗效。方法回顾分析接受VATS肺大疱切除术患者353例,其中常规三孔法VATS肺大疱切除172例,单操作孔VATS肺大疱切除181例。比较两组患者的手术时间、术中出血量、胸液引流量、术后1 d疼痛VAS评分、术后胸管留置时间、术后住院时间、复发率,分析两组临床资料差异。结果两组患者均无中转开胸。两组患者的手术时间、术中出血量、术后复发率比较差异无统计学意义;胸液引流量(t=-3.520,P=0.021)、术后1 d疼痛VAS评分(t=-6.726,P=0.000)、术后胸管留置时间(t=-4.268,P=0.000)、术后住院时间(t=-3.899,P=0.001)比较差异有统计学意义。结论单操作孔VATS肺大疱切除术安全可行,相对于传统三孔法VATS肺大疱切除术有创伤小,疼痛减轻,缩短术后住院时间等优势,可作为肺大疱外科治疗的优选术式。Objective To study the surgical characteristics, clinical value, and effect of VATS single utility port video-assisted thoracoscopic surgery. Methods We retrospectively analyzed 353 patients. 172 pulmonary bullae patients were treated with three port VATS, and 18l patients received with single utility port VATS. The operation time, blood loss, drainage volume, pain score, post-operative drainage time, hospital stay and recurrence rate be- tween the two groups were compared. Results The procedure was successful in all patients with no patients trans- ferred for open thoracotomy. There was no statistically significant difference in operation time, blood loss or recur- rence rate between the two groups. The drainage volume（ t = - 3. 520, P = 0.021 ） , pain score （ t = - 6.726, P = 0. 000） ,the post-operative drainage time （ t = - 4. 268, P = 0. 000 ） and hospital stay （ t = - 3. 899, P = 0. 001 ） were statistically significant. Conclusion The single utility port VATS is safe and feasible in the treatment of pul- monary bullae. Compared with the effects of three port VATS, it has the advantages of less harm, less pain and shorter hospital stay, thus becoming an optional surgical option for patients with pulmonary bullae.

关 键 词：自发性气胸 单操作孔 电视胸腔镜 肺大疱 

分 类 号：R655.3[医药卫生—外科学] R561.4[医药卫生—临床医学]