经胸腔镜激光松解胸膜粘连治疗难治性气胸  

THE APPLICATION OF THORACOSCOPIC LASER PLEUROLYSIS IN THE TREATMENT OF INTRACTABLE PNEUMOTHORAX WITH ADHESIONS

作　　者：郭纪全[1] 陈正贤[1] 高兴林[1] 李惠英[1] 刘伟兰[1] 

机构地区：[1]广东省人民医院呼吸科,广州510080

出　　处：《中国内镜杂志》2003年第3期6-7,共2页China Journal of Endoscopy

基　　金：广东省卫生厅科研基金资助项目 (B2 0 0 0 0 0 3)

摘　　要：目的 :观察经胸腔镜激光松解胸膜粘连在胸膜粘连所致的难治性气胸治疗中的应用价值。方法 :39例难治性气胸并发胸膜粘连者 ,局麻下经胸腔镜应用Nd :YAG激光松解粘连带 ,观察治疗前后胸腔闭式引流持续时间及治疗的安全性。结果 :39例患者胸膜粘连带全部松解成功 ,全部患者肺均完全复张 ,完全复张时间为2 .8± 1 .4d(1～ 5d) ,胸腔闭式引流持续时间由治疗前的 2 0 .5± 2 .1d(1 4～ 46d)缩短至治疗后 3 .8± 1 .2d(1～1 0d)。术后除 2例出现轻度发热外 ,未见出血及其它严重并发症。结论 :局麻下通过胸腔镜应用Nd :YAG激光松解胸膜粘连而治疗胸膜粘连所致的难治性气胸 ,方法简单 ,创伤小 ,安全有效 ,值得临床推广应用。Objective:To assess the efficacy of laser pleurolysis through thoracoscopy in the management of intractable pneumothorax with adhesions.Methods: From April 1998 to February 2002, 39 patients with intractable pneumothorax complicated with adhesions were treated with a new thoracoscopic method using Nd:YAG laser under local anesthesia. The duration of tube thoracostomy prior to and after treatment, and complications were observed.Results:All patients adhesions were successfully transected. The mean duration of lung expand was (2.8 ±1.4) days (range 1 to 5 days ) after treatment. The mean duration of tube thoracostomy prior to treatment was (20.5±2.1) days (range 14 to 46 days) and after treatment it was shortened to (3.8±1.2) days (range 1 to 10 days ). Two cases had mild fever, no other complications ocurred.Conclusion: Laser pleurolysis through thoracoscopy under local anesthesia was effective in the treatment of intractable pneumothorax with adhesions.

关 键 词：气胸 胸腔镜 激光 粘连带 胸膜粘连 并发症 胸腔闭式引流 

分 类 号：R655[医药卫生—外科学]