单孔胸腔镜治疗自发性气胸合并肺大疱的临床应用研究  

Clinical Efficacy of Single-port Thoracoscopy in the Treatment of Spontaneous Pneumothorax Complicated with Pulmonary Bullae

作　　者：戴宁凰 郑中锋 李威[1] 陆波[1] 庄淮千 DAI Ninghuang;ZHENG Zhongfeng;LI Wei(Department of Thoracic Surgery,Suqian People’s Hospital of Nanjing Drum Tower Hospital Group,Suqian City,Jiangsu Province 223800)

机构地区：[1]南京鼓楼医院集团宿迁市人民医院胸外科

出　　处：《医学理论与实践》2019年第24期3945-3947,共3页The Journal of Medical Theory and Practice

摘　　要：目的:[JP+2]分析单孔胸腔镜治疗自发性气胸合并肺大疱的效果,总结临床经验。方法:选取我科2015年1月—2019年6月48例自发性气胸合并肺大疱患者,依据手术方式分为单孔组和3孔组,每组24例。前者实施单孔胸腔镜下肺大疱切除术,后者实施传统3孔胸腔镜下肺大疱切除术。比较术中术后相关指标、疼痛评分、血清学指标。结果:单孔组术后引流量少于3孔组,术后拔除胸管时间早于3孔组,术后住院时间短于3孔组,差异具有统计学意义(P<0.05)。两组手术时间、术中出血量差异无统计学意义(P>0.05)。单孔组术后第1天、第5天肿瘤坏死因子-α、白细胞介素-6、白细胞介素-8水平均显著低于3孔组(P<0.05)。结论:与传统3孔法胸腔镜肺大疱切除术相比,单孔法治疗气胸合并肺大疱术后引流量更少,更早拔除胸管,住院时间更短,疼痛及炎症应激反应更轻,值得推广应用。[JP]Objective:To analyze the effect of single-port thoracoscopy in the treatment of spontaneous pneumothorax complicated with pulmonary bullae and summarize clinical experience.Methods:From January 2015 to June 2019,48 patients with spontaneous pneumothorax complicated with pulmonary bullae were selected and divided into single-port group and three-ports group according to the operation method.There were 24 cases in each group.The former was treated with single-port thoracoscopic bullaectomy,while the latter was treated with traditional three-ports thoracoscopic bullaectomy.Relevant operation indicators,pain scores and serological indicators were compared.Results:The drainage volume in the single-port group was less than that in the three-ports group,the time of thoracic tube removal after operation was earlier than that of three-ports group,postoperative hospital stay was shorter than that of three-ports group,and the difference was statistically significant(P<0.05).There was no significant difference in operation time and intraoperative blood loss between the two groups(P>0.05).Postoperative pain in single-port group was less than that in three-ports group(P<0.05).The levels of TNF-α,IL-6 and IL-8 in the single-port group were significantly lower than those in the three-ports group on the first and fifth days after operation(P<0.05).Conclusion:Compared with traditional three-ports thoracoscopic bullaectomy,single-port thoracoscopic bullaectomy has less drainage,earlier removal of thoracic tube,shorter hospitalization time and less pain,lighter Inflammatory stress response,which is worthy of popularization and application.

关 键 词：单孔胸腔镜 自发性气胸 肺大疱 

分 类 号：R655[医药卫生—外科学]