胸腔镜手术治疗双侧肺大疱合并自发性气胸的临床疗效及术后复发的危险因素分析  

Clinical Efficacy of Minimally Invasive Thoracoscopic Surgery and Risk Factors of Postoperative Recurrence for Bilateral Pneumothorax with Spontaneous Pneumothorax

作　　者：夏梅 李微娜 杜高丽 雷海燕 XIA Mei;LI Wei-na;DU Gao-li(The First Hospital Affiliated to AMU,Chong Qing 400038)

机构地区：[1]陆军军医大学第一附属医院胸外科,重庆400038

出　　处：《医学临床研究》2019年第10期1920-1922,共3页Journal of Clinical Research

摘　　要：【目的】探讨胸腔镜手术治疗双侧肺大疱合并自发性气胸的临床疗效及术后复发的危险因素.【方法】本研究为回顾性分析,选择2016年6月至2017年5月于本院接受治疗的94例双侧肺大疱合并自发性气胸患者作为研究对象,根据手术方式的不同,分为观察组(50例)和对照组(44例).对照组采用常规开胸手术治疗,观察组采用电视胸腔镜手术治疗.比较两组患者临床疗效、各项手术指标及术后并发症发生情况,分析两组患者术后复发的危险因素.【结果】观察组治疗总有效率明显高于对照组(P<0.05);术中出血量少于对照组,手术时间、胸管引流时间和住院时间均短于对照组(P<0.05);并发症发生率明显低于对照组(P<0.05),术后复发率明显低于对照组,但差异无统计学意义(P>0.05).对照组患者复发气胸和胸管留置时间>8 d发病率显著高于观察组(P<0.05).【结论】胸腔镜手术能提高双侧肺大疱合并自发性气胸患者的临床疗效,改善患者各项手术指标,降低术后并发症发生率,复发气胸和胸管留置时间>8d是患者术后复发的主要危险因素.【Objective】To analyze the clinical efficacy and postoperative recurrent risk of minimally invasive thoracoscopic surgery in the treatment of bilateral pulmonary bullae with spontaneous pneumothorax.【Methods】A total of 94 patients with bilateral pulmonary bullae and spontaneous pneumothorax,who were treated in our hospital from June 2016 to May 2017 were retrospectively analyzed.According to different surgical methods,patients were randomly divided into the observation group(n=50 cases)and the control group(n=44 cases).The control group received routine thoracotomy and the observation group received minimally invasive thoracoscopic surgery.The clinical efficacy and operative indicators of the two groups were compared.The postoperative complications and related risk factors of postoperative recurrence were analyzed between the two groups.【Results】The total effective rate of the observation group was 94.00%,which was significantly higher than that of the control group 75.00%(P<0.05).The intraoperative blood loss of the observation group was less than that of the control group.The operation time,chest tube drainage time and hospitalization time in the observation group were shorter than those in the control group.The differences between the two groups were statistically significant(P<0.05).The incidence of complications in the control group was 18.19%,which was significantly higher than that of the observation group 4.00%(P<0.05).However,there was no significant difference in recurrence rates between the two groups(P>0.05).The incidence of recurrent pneumothorax and chest tube indwelling time more than 8 day in control group was significant higher than that in observation group(P<0.05).【Conclusion】Minimally invasive thoracoscopic surgery improves the clinical efficacy of bilateral pulmonary bullae combined with spontaneous pneumothorax and reduces the incidence of postoperative complications.Our results suggests that recurrent pneumothorax and chest tube indwelling time>8d may be the main risk factors

关 键 词：气胸/外科学 胸腔镜检查 预后 

分 类 号：R561.4[医药卫生—呼吸系统]