胸腔镜下单操作孔手术与开胸手术治疗肺大疱的临床比较  

Clinical comparison of single hole thoracoscopic surgery and thoracotomy in the treatment of pulmonary bullae

作　　者：王庆淮[1] 赵飞兰[2] 谭宁[1] Wang Qinghuai Zhao Feilan Tan Ning(The Affiliated Hospital of Guangxi Medical University and Guigang People＇ s Hospital Chest Eighth,Guigang 537100, China Guangxi University of Traditional Chinese Medicine Department of Histology and Embryology, Nanning 530021, China)

机构地区：[1]广西医科大学第八附属医院暨贵港市人民医院胸心外科,贵港537100 [2]广西中医药大学组胚教研室,南宁530021

出　　处：《中华腔镜外科杂志（电子版）》2016年第5期301-304,共4页Chinese Journal of Laparoscopic Surgery(Electronic Edition)

摘　　要：目的观察胸腔镜下单操作孔手术与开胸手术治疗原发性自发性气胸(PSP)伴肺大疱形成的效果。方法通过回顾性收集2008年1月至2015年12月52例PSP伴肺大疱形成患者分成两组,A组30例[电视胸腔镜(VATS)下单操作孔肺大疱切除术],B组22例(常规开胸手术),比较两组的住院时间、术前和术后的血气分析[动脉血氧分压(PaO_2)、动脉血二氧化碳分压(PaCO_2)]、术后胸腔积液、胸顶残气、漏气、肺不张、肺部感染、术后复发等相关并发症。结果与B组比较,A组的住院时间(t=1.312,P=0.036)、术后血气分析PaO_2(t=60.206,P=0.038)、PaCO_2(t=32.025,P=0.009)、胸腔积液(t=2.035,P=0.042)、肺部感染(t=1.095,P=0.041)差异有统计学意义(P<0.05),治疗效果A组明显优于B组;与B组比较,A组的术后胸顶残气、漏气、肺不张、术后复发,差异无统计学意义(P>0.05)。结论采用VATS下单操作孔肺大疱切除术治疗PSP安全、有效,具有创伤小,并发症少,优于常规开胸手术治疗,能够在最短时间治愈PSP。早期VATS下单操作孔肺大疱切除术治疗PSP可作为优先治疗,具有可能性、必要性,具有较高的临床应用价值。Objective To observe the effect of thoracoscopic operation of single hole surgery and thoracic surgery for primary spontaneous pneumothorax （primary spontaneous p n e umothorax, P S P ） with pulmonary bulla formation effect. Methods We retrospectively collected from Jan. 2008 to Dec. 2015, 52 cases of PSP with pulmonary bulla formation were divided into two groups ： the A group of 30 cases （video-assisted thoracoscopic thoracoscopic surgery, VATS ; VATS single hole operation for resection of lung bullae） ; 22 cases in group B （conventional thoracotomy） , blood gas analysis of two groups were compared before and after hospitalization time, surgery （ PaO2, PaCO2 ） postoperative pleural effusion, chest top residual capacity, leakage, atelectasis, pulmonary infection, postoperative recurrence and other complications. Results A group compared with B group, hospitalization time （t = 1. 312, P = 0.036）, postoperative blood gas analysis of PaO2 （t = 60.206, P = 0.038）, PaCO2（t = 32.025, P = 0.009）, pleural effusion （t = 2. 035, P - 0.042） , pulmonary infection （t = 1. 095, P = 0.041） compared the differences, statistically significant （P 〈0. 05） , therapeutic effect the A group was significantly higher than that of B group; while in the top, leakage, postoperative residual atelectasis a nd postoperative recurrence are no difference, no statistical significance （P 〉 0.05）. Conclusions Using VATS single hole operation for pulmonary bulla resection for the treatment of PSP is safe and effective, with less trauma, less complications, better than conventional surgical treatment, can cure PSP in the shortest time. Early VATS single operation hole for pulmonary bullae resection for the treatment of PSP can be used as the preferred treatment of the possibility, necessity, has high clinical application value.

关 键 词：VATS PSP 肺大疱形成 单操作孔 常规开胸手术 

分 类 号：R655.3[医药卫生—外科学]