全胸腔镜与开胸手术治疗肺隔离症的疗效对比  

Comparative Analysis of Total Thoracoscopic Surgery Versus Open Thoracotomy in the Treatment of Pulmonary Sequestration

作　　者：王俊峰[1] 代雨 付玉东[1] 阚强波 侯波[1] 吉红波 黄若山 李明学[1] 贾国华[1] 赵章勇[1] 

机构地区：[1]云南省曲靖市第一人民医院胸心外科,曲靖655000 [2]曲靖医学高等专科学校,曲靖655000

出　　处：《中国微创外科杂志》2017年第4期325-328,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨全胸腔镜与开胸手术治疗肺隔离症(pulmonary sequestration,PS)的疗效。方法回顾性分析我院2003年1月~2016年3月手术治疗的48例肺隔离症资料,根据患者经济条件,行全胸腔镜手术18例,开胸手术30例。行肺叶切除或隔离肺切除术。比较2组的术中出血量、术后当日胸腔引流量、术后镇痛时间、胸腔引流时间及术后住院时间。结果与开胸组比较,全胸腔镜组术中出血少[(56.1±50.4)ml vs.(120.0±54.2)ml,t=-3.813,P=0.000],术后当日胸腔引流量少[(160.0±56.0)ml vs.(280.0±65.0)ml,t=-6.100,P=0.000],术后镇痛时间短[(2.4±1.2)d vs.(7.6±1.9)d,t=-9.650,P=0.000],胸腔引流时间短[(2.8±1.0)d vs.(5.7±1.5)d,t=-6.755,P=0.000],术后住院时间短[(6.5±2.6)d vs.(10.1±2.8)d,t=-4.160,P=0.000]。2组手术时间差异无统计学意义(P>0.05)。术后发生肺部感染、心律失常、肺不张全胸腔镜组分别为1、0、1例,开胸组为3、2、1例,2组差异无统计学意义(P>0.05)。结论全胸腔镜手术治疗肺隔离症较传统开胸手术创伤小,术中出血少,疼痛轻,恢复快,住院时间短,是一种可靠安全的手术方式。Objective To investigate the clinical efficacy of total thoracoscopic thoracotomy in the treatment of pulmonary sequestration（PS）. Methods We reviewed the surgical treatment data of 48 cases of PS in our hospital from January 2003 to March2016. According to the patient ＇s family economic conditions,there were 18 cases of total thoracoscopic surgery and 30 cases of thoracic surgery. Lobectomy or pneumonectomy isolation was performed. The amount of bleeding during the operation,postoperative thoracic drainage volume,postoperative analgesia time,postoperative chest drainage time,and length of postoperative hospital stay wrere compared between the two groups. Results As compared with the thoracotomy group,the total thoracoscopic group had less amount of bleeding during the operation [（56. 1 ± 50. 4） ml vs.（120. 0 ± 54. 2） ml,t =-3. 813,P = 0. 000 ],less volume of postoperative first day thoracic drainage [（160. 0 ± 56. 0） ml vs.（280. 0 ± 65. 0） ml,t =-6. 100,P = 0. 000 ],shorter postoperative analgesia time [（2. 4 ± 1. 2） d vs.（7. 6 ± 1. 9） d,t =-9. 650,P = 0. 000 ],shorter postoperative time of chest drainage [（2. 8 ± 1. 0） d vs.（5. 7 ± 1. 5） d,t =-6. 755,P = 0. 000],and shorter postoperative hospital stay [（6. 5 ± 2. 6） d vs.（10. 1 ± 2. 8） d,t =-4. 160,P = 0. 000]. There was no significant difference in operation time between the two groups（P〉0. 05）.Postoperative pulmonary infection,cardiac arrhythmia,and pulmonary atelectasis occurred in the total thoracoscopic group in 1,0,and1 case,and in the thoracotomy group in 3,2,and 1 case,respectively,showing no significant difference（P〉0. 05）. Conclusions Video-assisted thoracoscopic surgery in the treatment of pulmonary sequestration has less bleeding and less pain than the conventional thoracotomy surgery,with faster recovery after the surgery and less impact on the patient. It is a reliable surgical approach.

关 键 词：胸腔镜 开胸手术 肺隔离症 

分 类 号：R655.3[医药卫生—外科学]