低成本两孔胸腔镜手术治疗原发性气胸  

Low-cost biportal endoscopic surgery for primary spontaneous pneumothorax

作　　者：莫安胜[1] 杨小平[1] 冯志强[1] 罗玉忠[1] 莫绍雄[1] 吴军[1] 韦懿桐[1] 黄强信[1] Mo Ansheng Yang Xiaoping Feng Zhiqiang Luo Yuzhong Mo Shaoxiong Wu Jun Wei Yitong Huang Qiangxin.(Department of Cardiothoracic Surgery, First Affiliated Hospital of Guangxi Traditional Chinese Medical University, Nanning 530023, Chin)

机构地区：[1]广西中医药大学第一附属医院心胸血管外科,南宁530023

出　　处：《中华腔镜外科杂志（电子版）》2016年第5期281-284,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

基　　金：广西壮族自治区卫生与计划委员会课题(Z2013172)

摘　　要：目的探讨一种简单、微创、经济的腔镜方法治疗自发性气胸。方法收集2011年10月至2016年2月胸腔镜手术治疗自发性气胸84例,其中两孔胸腔镜肺大疱结扎54例(试验组),三孔胸腔镜肺大疱切割缝合器楔形切除30例(对照组)。试验组,根据胸壁不同厚度把肺大疱拉近操作孔或拉至操作孔或拉出操作孔用手直接结扎/缝扎后做机械摩擦的胸膜固定术;对照组按常规进行,用切割缝合器行肺楔形切后做机械摩擦的胸膜固定术。结果两组患者的临床效果差异无统计学意义(P>0.05),试验组的住院费用低于对照组[(16 747.30±2 586.41)元vs(21 088.54±6 005.68)元,P<0.05]。结论两孔胸腔镜下肺大疱用手缝扎/结扎技术治疗自发性气胸简单、微创、经济。Objective Endoscopic surgery offers many benefits. However,the need for more expensive endoscopic consumables brings further high medical costs. Here,we introduced a method of videoassisted thoracic surgery with no disposable consumables. Methods Between Oct. 2011 and Feb. 2016,a series of 84 patients with primary spontaneous pneumothorax underwent hand ligation of blebs under biportal video-assisted thoracoscopic surgery or bullectomy with stapler during triportal video-assisted thoracoscopic surgery. After treatment of blebs,pleural abrasion was performed with an electrocautery cleaning pad.Results Compared with the group treated by bullectomy with stapler,we found a significant reduction in postoperative costs in the group with bleb ligation. There was no difference in operating time,chest tube drainage（ P〉0. 05）, postoperative stay, and recurrence between the two groups [（ 16 747. 30 ±2 586. 41） yuan vs（ 21 088. 54 ± 6 005. 68） yuan,P〈0. 05]. Conclusions Biportal thoracoscopic bleb ligation for primary spontaneous pneumothorax is a safe,low-cost,simple and reliable procedure.

关 键 词：两孔胸腔镜 原发性气胸 结扎 医疗成本 

分 类 号：R655[医药卫生—外科学]