微创快速康复外科技术治疗原发性自发性气胸对呼吸功能的影响  

Effects of minimally invasive rapid rehabilitation surgery on respiratory function in primary spontaneous pneumothorax

作　　者：王庆淮[1] 谭宁[1] Wang Qinghnai Tan Ning(Department of Cardiothoracic Surgery, The Eighth Affiliated Hospital of Guangxi Medical University, Guigang City People’s Hospital, Guigang 537100, China)

机构地区：[1]广西医科大学第八附属医院,广西贵港市人民医院胸心外科,537100

出　　处：《中华胸部外科电子杂志》2017年第2期107-111,共5页CHINESE JOURNAL OF THORACIC SURGERY：Electronic Edition

基　　金：广西贵港市科学研究与技术开发计划项目(贵科转16070021)

摘　　要：目的探讨电视胸腔镜手术(VATS)+快速康复外科(FTS)技术下单操作孔行肺大疱切除术与传统开胸手术行肺大疱切除术治疗原发性自发性气胸(PSP)术后对患者呼吸功能的影响。方法回顾性分析2008年1月至2015年12月在广西贵港市人民医院胸心外科收治的52例PSP合并肺大疱形成的患者,其中VATS+FTS下单操作孔行肺大疱切除术30例(VATS+FTS组)、传统开胸手术行肺大疱切除术22例(传统开胸组),比较两组患者手术前后肺功能指标[第一秒用力呼气容积(FEV1)、每分最大通气量(MMC)、用力肺活量(FVC)]、血气分析指标[动脉血二氧化碳分压(PaCO_2)、动脉血氧饱和度(SaO_2)、剩余碱(BE)]以及术后并发症发生率的差异。结果两组患者术前肺功能和血气分析指标比较,差异均无统计学意义(P>0.05);但术后VATS+FTS组的肺功能和血气分析指标恢复均优于传统手术组,且VATS+FTS组的肺部感染发生率低于传统开胸组,差异均有统计学意义(P<0.05)。结论 VATS+FTS下单操作孔行肺大疱切除术治疗PSP患者术后对呼吸功能影响小,术后恢复快,有利于患者快速康复,降低并发症发生率,是一种比较理想的治疗手段。Objective To evaluate video-assisted thoracoscopic surgery （ video-assisted thoracoscopic surgery, VATS） ＋ rapid rehabilitation surgery （fast track surgery, FTS） technology of single operation hole for pulmonary bulla resection and conventional thoracotomy for pulmonary bulla resection in the treatment of primary spontaneous pneumothorax （PSP） for patients with respiratory function after operation. Methods A retrospective study was conducted on 52 cases of PSP with pulmonary bullae formation from January 2008 to December 2015. Among them, 30 cases （VATS＋FTS group） underwent the the VATS ＋ FTS operation for single hole pulmonary bullae resection, and 22 cases （traditional thoracotomy group） received the conventional thoracotomy for resection of lung bullae. The lung function indexes [forced expiratory volume in first second （FEVi ） , maximum per minute capacity （MMC）, forced vital capacity （FVC）] , blood gas analysis index [ arterial partial pressure of carbon dioxide （PaCO2 ） ,arterial oxygen saturation （ SaO2 ） , residual alkali （BE）] and postoperative complications were compared between the two groups before and after surgeries. Results There was no significant difference in lung function and blood gas analysis between the two groups （P〉 0. 05）. However, the recovery of lung function and blood gas analysis in VATS＋FTS group was better than that in traditional surgery group, and the incidence of pulmonary infection in VATS＋FTS group was lower than that in traditional thoracotomy group （P〈0. 05）. Conclusions Patients with PSP whounderwent the VATS＋FTS operation for single hole pulmonary bullae resection have better respiratory function, faster postoperative recovery rate,lower postoperative complications; thus it is an ideal treatment method.

关 键 词：原发性自发性气胸 肺大疱 电视胸腔镜手术 快速康复外科 呼吸功能 

分 类 号：R655[医药卫生—外科学]