胸腔镜下徒手结扎肺大疱治疗原发性气胸的临床研究  

Hand ligation of pulmonary bullae under thoracoscopy for primary spontaneous pneumothorax

作　　者：郑昌泽 宾能康 莫安胜 路运鑫 郑媛予 陈诗梅 Zheng Changze;Bin Nengkang;Mo Ansheng;Lu Yunxin;Zheng Yuanyu;Chen Shimei(The First Clinical Medical College of Guangxi Medical University,Nanning 530021,China;Wuming School of Clinical Medicine of Guangxi Medical University,Nanning 530199,China;Department of Cardiothoracic Surgery,Wuming Hospital of Guangxi Medical University,Nanning 530199,China;School of Basic Medical Sciences,Guangxi Medical University,Nanning,530021,China)

机构地区：[1]广西医科大学第一临床医学院,广西南宁530021 [2]广西医科大学武鸣临床医学院,广西南宁530199 [3]广西医科大学附属武鸣医院心胸外科,广西南宁530199 [4]广西医科大学基础医学院,广西南宁530021

出　　处：《中西医结合心血管病电子杂志》2024年第1期17-21,4,共6页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

基　　金：2023年广西医疗卫生适宜技术开发与推广应用项目(S2023098);国家级“大学生创新创业训练计划”项目(202410598056X)

摘　　要：目的 探讨电视辅助胸腔镜手术下徒手结扎法处理肺大疱的临床效果和经济效益。方法 选取2020年11月至2023年11月在广西医科大学附属武鸣医院胸外科就诊的35例自发性气胸患者,根据手术方法分为徒手结扎组(n=20)和切割缝合器组(n=15),根据患者情况选择气管导管插管(单腔/双腔)以及切口数量(单孔/两孔)。比较两组患者的术后炎症指标、手术时间、术后引流管留置时间、术后住院天数、总住院天数、手术及住院费用、术后并发症发生率和复发率。结果 与切割缝合器组相比,徒手结扎组术后住院天数短、总住院天数少、手术费用低、住院费用低(P<0.05)。两组在术后炎症指标、手术时间、术后引流管留置时间、术后并发症发生率及复发率方面比较,差异无统计学意义(P>0.05)。结论 在胸腔镜下徒手结扎组与切割缝合器组有着相同的临床效果,但徒手结扎组能够缩短住院时间及降低医疗费用。Objective To investigate the clinical efficacy and economic benefits of hand ligation in the treatment of pulmonary bullae under video-assisted thoracoscopic surgery.Methods Between November 2020 and November 2023,a series of 35 patients with primary spontaneous pneumothorax were treated in the Department of Cardiothoracic Surgery at Wuming Hospital of Guangxi Medical University.The choice of endotracheal intubation(single-lumen/double-lumen)and incisiontype(uniportal/biportal)was made according to individual patient conditions.We compared postoperative inflammatory indicators,operating time,duration of chest tube drainage,postoperative hospital stay,total hospital stay,surgical and hospital costs,as well as the incidence of postoperative complications between the hand ligation group and the bullectomy with stapler group.Results Compared with the bullectomy with stapler group,the hand ligation group experienced a significant reduction in postoperative hospital stay,total hospital stay,and both surgical and hospital costs(P<0.05).No significant differences were observed between the two groups regarding postoperative inflammatory indicators,operating time,duration of chest tube drainage,and incidence of postoperative complications(P>0.05).Conclusion The hand ligation group under thoracoscopy achieved comparable clinical outcomes to the bullectomy with stapler group;however,hand ligation group was able to shorten hospital stay and reduce medical costs.

关 键 词：电视辅助胸腔镜 结扎 原发性气胸 肺大疱 

分 类 号：R655[医药卫生—外科学]