单孔电视辅助胸腔镜技术联合碘酊机械胸膜固定术治疗自发性气胸的临床效果及安全性研究  

Study on the Clinical Effect and Safety of Single-hole Video-assisted Thoracoscopic Surgery Technique Combined with Iodine Tincture Mechanical Pleurodesis in the Treatment of Spontaneous Pneumothorax

作　　者：郭宗荣 肖向红 王志勇 钟继平 GUO Zongrong;XIAO Xianghong;WANG Zhiyong;ZHONG Jiping(Department of Cardiothoracic Surgery,Yudu County People's Hospital,Yudu 342300,Jiangxi,China)

机构地区：[1]于都县人民医院胸心外科,江西于都342300

出　　处：《医学信息》2024年第22期86-89,共4页Journal of Medical Information

摘　　要：目的研究单孔电视辅助胸腔镜技术(VATS)联合碘酊机械胸膜固定术治疗自发性气胸(SP)的临床效果与安全性。方法选取2020年9月-2023年8月于都县人民医院收治的62例SP患者,经随机数字表法分为单孔组(31例)与传统组(31例)。单孔组行单孔VATS+碘酊机械胸膜固定术治疗,传统组采用传统VATS+碘酊机械胸膜固定术治疗,比较两组手术疗效、围术期指标(手术时间、术中出血量、胸管引流时间、术后引流量)、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]及术后并发症。结果两组手术优良率比较,差异无统计学意义(P>0.05);单孔组手术时间、胸管引流时间短于传统组,且术中出血量、术后引流量少于传统组(P<0.05);术后1 d,两组PaO_(2)升高、PaCO_(2)降低,且单孔组PaO_(2)高于传统组,PaCO_(2)低于传统组(P<0.05);单孔组术后并发症发生率低于传统组(P<0.05)。结论单孔VATS联合碘酊机械胸膜固定术治疗SP效果肯定,在保证手术疗效的同时,可减少术中出血,缩短手术及胸管引流时间,改善患者血气指标,并降低其术后并发症风险。Objective To study the clinical effect and safety of single-hole video-assistedthoracoscopic surgery(VATS)combined with iodine tincture mechanical pleurodesis in the treatment of spontaneous pneumothorax(SP).Methods A total of 62 patients with SP admitted to Yudu People's Hospital from September 2020 to August 2023 were selected and divided into single-port group(31 patients)and traditional group(31 patients)by random number table method.The single-port group was treated with single-port VATS+iodine tincture mechanical pleurodesis,while the traditional group was treated with traditional VATS+iodine tincture mechanical pleurodesis.The surgical efficacy,perioperative indexes(operation time,intraoperative blood loss,chest tube drainage time,postoperative drainage volume),blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))]and postoperative complications were compared between the two groups.Results There was no significant difference in the excellent and good rate of operation between the two groups(P>0.05).The operation time and chest tube drainage time of the single-hole group were shorter than those of the traditional group,and the intraoperative blood loss and postoperative drainage volume were less than those of the traditional group(P<0.05).One day after operation,PaO_(2) increased and PaCO_(2) decreased in the two groups,and PaO_(2) in the single-hole group was higher than that in the traditional group,and PaCO_(2) was lower than that in the traditional group(P<0.05).The incidence of postoperative complications in the single-hole group was lower than that in the traditional group(P<0.05).Conclusion Single-hole VATS combined with iodine tincture mechanical pleurodesis is effective in the treatment of SP,which can reduce intraoperative bleeding,shorten the time of operation and chest tube drainage,improve the blood gas index of patients and reduce the risk of postoperative complications while ensuring the curative effect of operation.

关 键 词：自发性气胸 单孔电视辅助胸腔镜技术 碘酊机械胸膜固定术 血气指标 术后并发症 

分 类 号：R561.4[医药卫生—呼吸系统]