单孔胸腔镜手术与传统胸腔镜手术在自发性气胸治疗中的疗效观察  

Comparison of clinical effects between single-port video-assisted thoracoscopic surgery and traditional thoracoscopic surgery for spontaneous pneumothorax

作　　者：周静 孙仲涛[1] 陈晓[2] ZHOU Jing;SUN Zhong-tao;CHEN Xiao(Department of Thoracic Surgery, Fuyaag People＇ s Hospital, Fuyang, Anhui 236000, Chin)

机构地区：[1]阜阳市人民医院胸外科,安徽阜阳236000 [2]蚌埠医学院第一附属医院老年病科,安徽蚌埠233004

出　　处：《中华全科医学》2018年第8期1279-1282,共4页Chinese Journal of General Practice

基　　金：安徽省自然科学基金青年项目(1708085QH219)

摘　　要：目的比较单孔法胸腔镜手术(single-port video-assisted thoracoscopic surgery,SPVATS)与传统胸腔镜手术(video-assisted thoracoscopic surgery,VATS)治疗自发性气胸的效果,探讨SPVATS的操作要点、临床疗效以及推广价值。方法回顾性分析自2015年1月—2017年6月阜阳市人民医院收治的106例单侧自发性气胸患者的临床资料,根据手术方式分为单孔组64例(SPVATS组,采用单孔法胸腔镜手术)、传统组42例(VATS组,采用传统胸腔镜手术),比较2组间手术时间、手术出血量、引流管放置时间、术后引流量、住院时间及术后24 h疼痛VAS评分,分析2组临床资料的差异。结果 2组手术均顺利完成,无中转开胸及围手术期死亡;SPVATS组术后24 h疼痛VAS评分与VATS组比较差异有统计学意义(t=12.740,P<0.001),SPVATS组手术时间[(50.39±9.58)min]、手术出血量[(42.70±9.54)ml]、引流管放置时间[(3.31±0.90)d]、术后引流量[(235.62±74.38)ml]、住院时间[(4.73±1.38)d]与VATS组比较差异均无统计学意义(均P>0.05)。结论 SPVATS治疗自发性气胸与VATS相比同样安全有效,操作方便,且具有术后疼痛轻的优势,临床价值显著,值得作为自发性气胸外科治疗的首选术式大力推广。Objective To compare the clinical effect between single-port video-assisted thoracoscopic surgery （SPVATS） and traditional thoracoscopic surgery（VATS） in the treatment of spontaneous pneumothorax, and discuss the key points of operation, clinical efficacy and value of popularization of SPVATS. Methods The clinical data of 106 cases of spontane- ous pneumothorax in our hospital from January, 2015 to June, 2017 were reviewed. The patients were divided into SPVATS group （64 cases） and VATS group （42 cases）. The operative time, bleeding during the operation, drain time, postoperative drainage volume, and length of stay, and VAS in 24 h after the operation were compared between the two groups. Results The operations were successful in both groups, and there was no conversion to thoracotomy case or perioperative death cases. The patients in SPVATS group had significantly lighter postoperative pain than patients in VATS group（ t = 12. 740, P 〈 0. 001 ）. The operation time （50.39 ± 9.58 ） min, intraoperative blood loss （4：2.70 ±9.54 ） ml, chest tube drainage time （ 3.31± 0.90 ） d, postoperative drainage volume （ 235.62 ± 74.38 ） ml and postoperative length of hospital stay （4.73 ± 1.38 ）d showed no significant difference between two groups （P 〉 0.05 ）. Conclusion Single-port video-assisted thoracoseopie surgery in the treatment of spontaneous pneumothorax has the same safety, easy operation and less pain as compared with VATS, which is worth to be promoted.

关 键 词：单孔法胸腔镜手术 传统胸腔镜手术 自发性气胸 肺大疱 

分 类 号：R561.4[医药卫生—呼吸系统] R616.5[医药卫生—内科学]