单孔与三孔胸腔镜治疗肺大泡并自发性气胸的临床对比研究  

A Comparative Study of Single Hole and Three Hole Thoracoscopy in the Treatment of Bullae and Spontaneous Pneumothorax

作　　者：孙建[1] 余觅 唐莉 代文静[1] 李万成[1] SUN Jian;YU Mi;TANG Li;DAI Wen-jing;LI Wan-cheng(Department of Respiratory Medicine,The First Affiliated Hospital of Chengdu Medical College,Chengdu,Sichuan,610500,China)

机构地区：[1]成都医学院第一附属医院呼吸内科,四川成都610500

出　　处：《现代生物医学进展》2021年第1期162-165,共4页Progress in Modern Biomedicine

基　　金：四川省教育厅科研计划项目(16ZB0292);成都医学院第一附属医院科研资助项目(CYFY2017GLPHX05)。

摘　　要：目的:对比肺大泡并自发性气胸患者经单孔与三孔胸腔镜治疗后的临床疗效。方法:回顾性分析2016年6月~2019年4月期间我院收治的93例肺大泡并自发性气胸患者的临床资料,根据手术方式的不同将其分为单孔组(n=45,单孔胸腔镜治疗)和三孔组(n=48,三孔胸腔镜治疗),比较两组患者围术期指标、视觉疼痛模拟量表(VAS)评分、并发症、血气分析指标、肺功能指标。结果:单孔组住院时间短于三孔组,出血量少于三孔组(P<0.05);两组手术时间、术后引流量比较无差异(P>0.05)。两组术后并发症发生率比较无差异(P>0.05)。两组患者术后3d血氧分压(PaO2)较术前升高,且单孔组较三孔组高(P<0.05);两组患者术后3d二氧化碳分压(PaCO2)较术前降低,且单孔组低于三孔组(P<0.05)。两组患者术后3d第一秒用力呼吸容积(FEV1)较术前升高,肺总量(TLC)及肺残气量(RV)较术前降低(P<0.05),但组间比较无统计学差异(P>0.05)。两组患者术后1d、术后2d、术后3d VAS评分呈先升高后降低趋势,且单孔组低于三孔组(P<0.05)。结论:与三孔胸腔镜治疗相比,单孔胸腔镜治疗肺大泡并自发性气胸,可有效减少术中出血量,减轻疼痛,促进患者恢复,同时还可改善血气指标,安全性较好。Objective: To compare the clinical effect of single hole and three hole thoracoscopy in the treatment of bullous and spontaneous pneumothorax. Methods: The clinical data of 93 patients with pulmonary bullae and spontaneous pneumothorax who were admitted to our hospital from June 2016 to April 2019 were analyzed retrospectively. According to the different operation methods, they were divided into single hole group(n=45, single hole thoracoscopy) and three hole group(n=48, three hole thoracoscopy). The perioperative indexes, visual pain simulation scale(VAS), complications, blood gas analysis indexes and pulmonary function indexes were compared between the two groups. Results: The hospitalization time in the single hole group was shorter than that in the three hole group, and the amount of bleeding was less than that in the three hole group(P<0.05). There was no significant difference in operation time and postoperative drainage between the two groups(P>0.05). There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). The partial pressure of blood oxygen(PaO2) of the two groups at 3 d after operation were higher than that of the patients before operation, and that in the single hole group was higher than that in the three hole group(P<0.05).The partial pressure of carbon dioxide(PaCO2) of the two groups at 3 d after operation were lower than that before operation, and that in the single hole group was lowerr than that in the three hole group(P<0.05). The first second forced breathing volume(FEV1) of the patients in the two groups at 3 d after operation were higher than that before the operation, total lung volume(TLC) and residual lung volume(RV) were lower than those before operation(P<0.05), but there was no significant difference between the two groups(P > 0.05).The VAS scores of patients in the two groups increased first and then decreased at 1 d after operation, 2 d after operation and 3 d after operation, and that in the single hole group was lowerr tha

关 键 词：单孔胸腔镜 三孔胸腔镜 肺大泡 自发性气胸 疗效 

分 类 号：R561.4[医药卫生—呼吸系统]