单孔法和单操作孔法胸腔镜手术治疗自发性气胸并肺大泡的效果比较  

Comparison of Clinical Effects between Single-hole and Double-holes Video-assisted Thorascopic Surgery in Treatment of Spontaneous Pneumothorax Combined with Pulmonary Bulla

作　　者：赵亮[1] 董天剑[1] 翟建宾[1] 童雷[1] 刘新凤[1] 鲍玫[1] 于华明[1] 

机构地区：[1]解放军白求恩国际和平医院心胸外科,石家庄050082

出　　处：《临床误诊误治》2016年第11期93-95,共3页Clinical Misdiagnosis & Mistherapy

摘　　要：目的观察比较单孔法和单操作孔法胸腔镜手术(video-assisted thoracoscopic surgery,VATS)治疗自发性气胸并肺大泡的临床效果。方法选择2015年2月—2016年2月解放军白求恩国际和平医院收治的自发性气胸并肺大泡40例,随机将其分为单孔组(18例)和单操作孔组(22例)两组,单孔组采用单孔法行VATS,单操作孔组采用单操作孔法进行VATS,观察比较两组临床相关指标。结果两组均在胸腔镜下完成手术,无中转开胸病例,术后3个月内均无复发。两组手术时间、术中出血量、术后胸腔积液引流量、术后漏气率以及胸腔置管时间比较差异无统计学意义(P>0.05);但单孔组术后第3天疼痛程度轻于单操作孔组,而术中使用切割缝合器钉数及人均住院费用显著多于或高于单操作孔组,差异具有统计学意义(P<0.05)。结论单孔法VATS和单操作孔法VATS均是治疗自发性气胸并肺大泡的可靠方法,虽单孔法VATS术后疼痛程度较轻,但人均住院费用较高。Objective To compare clinical effects of single-hole and double-holes video-assisted thorascopic surgery（ VATS） in treatment of spontaneous pneumothorax combined with pulmonary bulla. Methods A total of 40 patients with spontaneous pneumothorax combined with pulmonary bulla during February 2015 and February 2016 were randomly divided into single-hole（ n = 18） and double-holes groups（ n = 22）. Single-hole group underwent single-hole VATS,while double-holes group received double-holes VATS. Related indexes of clinical data were observed and compared in two groups. Results All surgeries were successfully performed without conversion of open surgery or recurrence within postoperative 3 months. There were no statistically significant differences in operative time,intraoperative volume of blood loss,postoperative volume of hydrothorax draining,postoperative rate of air leak and indwelling time of chest tube between two groups（ P〉0. 05）. In singlehole group,pain score at postoperative 3rdd was significantly lower,while usage amount of cutting- stiching instrument nails and average cost of hospitalization were significantly higher than those in double-holes group（ P〈0. 05）. Conclusion Both single-hole and double-holes VATS in treatment of spontaneous pneumothorax combined with pulmonary bulla are feasible.Single-hole VATS can achieve slight postoperative pains,but the total cost of hospitalization per is expensive.

关 键 词：气胸 肺大泡 胸腔镜检查 肺外科手术 

分 类 号：R655.3[医药卫生—外科学]