单操作孔胸腔镜下胸膜灼烧胸膜固定术治疗原发性自发性气胸的临床研究  

Clinical Study of Pleural Cauterizing Pleurodesis in Treatment of Primary Spontaneous Pneumothorax by Single Utility Port Video-assisted Thoracoscopic Surgery

作　　者：边铁军 赵虎[2] BIAN Tiejun;ZHAO Hu(Beijing Shunyi Hospital,Beijing 101300,China;不详)

机构地区：[1]北京市顺义区医院,北京101300 [2]北京医科大学第一附属医院

出　　处：《中外医学研究》2022年第13期15-18,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:探讨胸膜灼烧胸膜固定在单操作孔胸腔镜手术治疗原发性自发性气胸(primary spontaneous pneumothorax,PSP)患者中的可行性及效果。方法:回顾性研究2018年5月-2020年5月北京市顺义区医院收治的PSP患者60例,根据治疗方法不同分为胸膜灼烧组与胸膜机械摩擦组,每组30例。对所有患者行单操作孔胸腔镜肺大疱切除手术,胸膜灼烧组术中给予胸膜灼烧胸膜固定术治疗,胸膜机械摩擦组行胸膜机械摩擦胸膜固定。观察两组患者手术指标、术后临床指标及复发情况。结果:胸膜灼烧组手术时间短于胸膜机械摩擦组,术中出血量少于胸膜机械摩擦组,比较差异均有统计学意义(P<0.05)。胸膜灼烧组术后体温>38℃、WBC>10×10^(9)/L的患者占比少于胸膜机械摩擦组,胸腔引流量少于胸膜机械摩擦组,置管时间、住院时间少于胸膜机械摩擦组,疼痛评分低于胸膜机械摩擦组,比较差异均有统计学意义(P<0.05)。胸膜灼烧组并发症发生率及复发率均为0,低于胸膜机械摩擦组的6.7%、3.3%,但比较差异无统计学意义(P>0.05)。结论:胸膜灼烧胸膜固定术在单操作孔胸腔镜手术治疗PSP能减少并发症,减轻术后疼痛,这种方法值得临床推广。Objective:To investigate the feasibility and efficacy of pleural cauterizing pleurodesis in single utility port video-assisted thoracoscopic surgery for patients with primary spontaneous pneumothorax(PSP).Method:A total of 60 patients with PSP treated in Beijing Shunyi Hospital from May 2018 to May 2020 were retrospectively studied.According to different quality methods,they were divided into pleural cauterization group and mechanical pleurodesis group,with 30 cases in each group.All patients underwent single-operating hole video-assisted thoracoscopic surgery.During the operation,the pleural cauterization group was given cauterizing pleurodesis,and the mechanical pleurodesis group was given mechanical pleurodesis.The surgical indicators,postoperative clinical indicators and recurrence were observed in the two groups.Result:The operation time in the pleural cauterization group was shorter than that in mechanical pleurodesis group,and the intraoperative blood loss was less than that in the mechanical pleurodesis group,and the differences were statistically significant(P<0.05).The proportion of patients with postoperative body temperature>38℃and WBC>10×10^(9)/L in the pleural cauterization group were less than those in the mechanical pleurodesis group,the chest drainage volume was less than that in the mechanical pleurodesis group,and the intubation time and hospital stay were less than those in the mechanical pleurodesis group,the pain score was lower than that in the mechanical pleurodesis group,the differences were statistically significant(P<0.05).The incidence of complications and recurrence in the pleural cauterization group were 0,lower than 6.7%,3.3%in the mechanical pleurodesis group,there were no significant differences(P>0.05).Conclusion:Cauterizing pleurodesis can reduce complications and reduce postoperative pain in single utility port video-assisted thoracoscopic surgery for PSP.This method is worthy of clinical promotion.

关 键 词：单操作孔电视胸腔镜 原发性自发性气胸 胸膜灼烧 胸膜固定 胸腔引流 并发症 疼痛评分 复发 

分 类 号：R655[医药卫生—外科学]