腋前线第4肋间单孔胸腔镜肺大疱切除术治疗原发性气胸临床研究  

Clinical study on the treatment of primary pneumothorax by thoracoscopic bullae resection in the 4th intercostal space in anterior axillary line

作　　者：贺魁勇 刘文超 王辉 HE Kuiyong;LIU Wenchao;WANG Hui(Department of Cardiothoracic Surgery,People's Hospital of Dancheng,Dancheng 477150,Henan,China)

机构地区：[1]河南省周口市郸城县人民医院心胸外科,河南郸城477150

出　　处：《右江医学》2020年第9期691-694,共4页Chinese Youjiang Medical Journal

摘　　要：目的对比腋前线第4肋间与腋中线第7肋间单孔胸腔镜肺大疱切除术治疗原发性气胸的临床疗效及预后。方法将2016年6月至2018年6月间收治的126例原发性气胸患者作为研究对象,采用区组随机化法将其分为对照组63例及试验组63例,对照组患者以腋中线第7肋间为手术切口,试验组患者以腋前线第4肋间为手术切口,分别行单孔胸腔镜肺大疱切除术,切口均为2 cm,对比两组患者术中及术后各指标数据。结果两组患者的手术时长及术中失血量对比,差异无统计学意义(P>0.05);试验组患者术后引流量、引流管留置时间及住院时间均显著少于对照组(P<0.001);术前及术后即刻,两组患者VAS评分对比,差异无统计学意义(P>0.05);术后12 h及24 h,试验组患者VAS评分显著低于对照组(P<0.001);试验组患者不良反应发生率显著低于对照组(P<0.05)。结论针对治疗原发性气胸患者,以腋前线第4肋间为切口行单孔胸腔镜肺大疱切除术,安全性较高,且能够得到更好的术后恢复效果。Objective To compare the clinical effect and prognosis of primary pneumothorax treated with thoracoscopic bullae resection in the 4 th intercostal space in anterior axillary line and the 7 th intercostal space in midaxillary line.Methods 126 cases of idiopathic pneumothorax admitted to hospital from June 2016 to June 2018 were selected as research objects,and they were divided into control group(63 cases)and experimental group(63 cases)by block randomization.The 7 th intercostal space in middle axillary line was used as surgical incision in the control group,and the 4 th intercostal space in anterior axillary line was used as the surgical incision in the experimental group.Single hole thoracoscopic pulmonary bullae resection were performed in the two groups respectively,and the incisions of both groups were 2 cm.And then,the intraoperative and postoperative data of the two groups were compared.Results After operation,there was no statistically significant difference between the two groups in operation duration and intraoperative blood loss(P>0.05).Postoperative drainage volume,indwelling time of drainage tube and length of hospital stay in the experimental group were significantly less than those in the control group(P<0.001).There was no statistically significant difference in VAS scores between the two groups before and immediately after surgery(P>0.05).At 12 h and 24 h after surgery,VAS score in the experimental group was significantly lower than that in the control group(P<0.001),and the incidence of adverse reactions in the experimental group was significantly lower than that in the control group(P<0.05).Conclusion For patients with primary pneumothorax,single hole thoracoscopic pulmonary bullae resection in the 4 th intercostal space in anterior axillary line is safe and can obtain better postoperative recovery.

关 键 词：腋前线第4肋间 腋中线第7肋间 单孔胸腔镜 肺大疱切除术 原发性气胸 

分 类 号：R561.4[医药卫生—呼吸系统]