单孔胸腔镜下肺大疱切除术治疗自发性气胸的临床研究  

Clinical study on single-pore thoracoscopic bullectomy in the treatment of Spontaneous pneumothorax

作　　者：糜烨东 虞桂平[1] 蒋薛伟 黄斌[1] 单一波 MI Yedong;YU Guiping;JIANG Xuewei;HUANG Bin;SHAN Yibo(Department of Cardiothoracic Surgery,Jiangyin People's Hospital in Jiangsu Province,Jiangyin 214400,China)

机构地区：[1]江苏省江阴市人民医院胸心外科,江苏江阴214400

出　　处：《中国现代医生》2020年第33期77-80,共4页China Modern Doctor

基　　金：江苏省青年医学重点人才项目(QNRC2016135);江苏省无锡市卫生健康委员会科研项目(MS201906)。

摘　　要：目的探讨单孔胸腔镜下肺大疱切除术治疗自发性气胸的临床效果。方法自2018年6月~2019年11月,选取江阴市人民医院胸心外科收治的自发性气胸患者50例,根据手术方式分为两组,行单孔胸腔镜下肺大疱切除术者为观察组(n=25),行单操作孔胸腔镜下肺大疱切除术者为对照组(n=25)。比较两组患者术前知晓率,记录并分析两组患者的手术时间、术中出血量、胸腔置管时间、胸腔置管总引流量、术后1 d疼痛评分、住院时间等情况,比较两组患者术后满意度。结果两组患者术前知晓率均为88%,差异无统计学意义(P>0.05)。观察组患者的手术时间、术中出血量、胸腔置管时间、胸腔置管总引流量、术后1 d疼痛评分及住院时间均少于对照组,除手术时间外,差异均有统计学意义(P<0.05)。两组患者术后满意度比较,观察组(92%)高于对照组(80%),但差异无统计学意义(P>0.05)。结论单孔胸腔镜下肺大疱切除术治疗自发性气胸效果佳,缩短患者胸腔置管时间和住院时间、减少术中出血量、减轻疼痛,患者术后满意度更高,值得进一步在临床中推广。Objective To explore the clinical effect of single-pore thoracoscopic bullectomy in the treatment of spontaneous pneumothorax.Methods From June 2018 to November 2019,A total of 50 patients with spontaneous pneumothorax who were admitted to the Department of Cardiothoracic Surgery at Jiangyin People's Hospital were selected.They were divided into two groups according to different surgical methods.The patients undergoing bullectomy under single-pore thoracoscopy were assigned into the observation group(n=25),and the patients undergoing bullectomy under single operation pore thoracoscopy were assigned into the control group(n=25).The rate of surgery awareness was compared between the two groups.The duration of operation,intraoperative blood loss,thoracic catheterization time,thoracic catheterization total drainage,pain score one day after surgery,and length of hospital stay were recorded and analyzed.The patients'satisfaction after surgery was compared.Results The surgery awareness rate before treatment was 88%for both groups,and the difference was not statistically significant(P>0.05).In the observation group,the duration of operation,intraoperative blood loss,thoracic catheterization time,total thoracic catheter drainage,pain score one day after surgery,and length of hospital stay were all less than those in the control group.Except for the duration of surgery,all the differences were statistically significant(P<0.05).The postoperative satisfaction was compared between the two groups.The observation group(92%)was higher than the control group(80%),but the difference was not statistically significant(P>0.05).Conclusion Single-pore thoracoscopic bullectomy is effective in the treatment of spontaneous pneumothorax,which shortens the time of thoracic catheterization and length of stay,reduces intraoperative blood loss,and alleviates patient pain.The postoperative satisfaction of patients is higher and it is worthy of further promotion in clinical settings.

关 键 词：单孔法 胸腔镜 自发性气胸 肺大疱 

分 类 号：R561.4[医药卫生—呼吸系统]