单孔和三孔电视胸腔镜治疗自发性气胸的对比研究  

Single-port video-assisted thoracic surgery versus three-port video- assisted thoracic surgery for primary spontaneous pneumothorax

作　　者：张涛 张喜军 

机构地区：[1]咸阳市中心医院胸外科,咸阳712000

出　　处：《国际外科学杂志》2017年第6期397-400,共4页International Journal of Surgery

摘　　要：目的探讨单孔与三孔电视胸腔镜治疗自发性气胸的临床疗效。方法回顾性分析2012年4月-2013年4月就诊于咸阳市中心医院胸外科诊断为自发性气胸的患者58例，按照随机数字表法将患者随机分配至单孔电视胸腔镜组28例，三孔电视胸腔镜组30例，并用电话随访法进行随访。采用SPSS19．0统计学软件对两组患者的临床指标、并发症发病率及生存资料进行统计学分析。结果与传统三孔电视胸腔镜手术相比，单孔电视胸腔镜手术具有术后住院时间更短（t=-4．151，P=0．001）、引流持续时间更短（t=-3．436，P=0．001）、切口满意度评分更高（t=-6．141，P=0．001）、术后6h疼痛视觉评分更低（t=-4．942，P：0．006）、术后24h疼痛视觉评分更低（t=-3．326，P=0．02）及术后胸腔积液的发病率更低（Z=-2．096，P=0．036）的优点，但手术时间长（t=6．369，P=0．000），在其他并发症发病率、总生存时间（χ2=0．001，P=0．979）及中位无疾病进展生存时间（χ2=1．797，P=0．180）方面差异无明显统计学意义（P〉0．05）。结论与三孔电视胸腔镜手术相比，单孔电视胸腔镜手术在住院时间短、术后疼痛轻等方面具有一定的优势，但不能明显缩短手术时间和改善患者术后生活质量。Objective To explore the effects of single-port video-assisted thoracic surgery versus three-port videoassisted thoracic surgery for primary spontaneous pneumothorax. Methods Video-assisted thoracic surgery was performed for primary spontaneous pneumothorax in 58 patients from April 2012 to April 2013. We reviewed the medical records of these 58 patients, retrospectively. Thirty patients underwent the three-port video-assisted thoracic surgery （three-port group ） and 28 patients underwent the single-port video-assisted thoracic surgery （single-port group）. Following the operation, clinical outcomes, complications and overall survival were evaluated. Results There was no difference in patient characteristics between two groups. Compared with three-port video- assisted thoracic surgery, tingle-port video-assisted thoracic surgery had shorter hospital stay, shorter chest tube drainage, lower visual analog scale score score of 6 h postoperative pain and visual analog scale score score of 24 h postoperative pain. Meanwhile, there were no statistical differences between both groups in intraoperative bleeding, overall survival and progression-free survival. Conclusions Single-port video-assisted thoracic surgery can reduce the postoperative pain and get better clinical outcomes in treatment of primary spontaneous pneumothorax.

关 键 词：胸腔镜 单孔目 气胸 病例对照研究 

分 类 号：R655[医药卫生—外科学]