单操作孔和3孔电视胸腔镜治疗自发性气胸疗效分析

发布时间：2018-05-21 13:17

本文选题：单操作孔 + 胸腔镜　；参考：《延安大学》2013年硕士论文

【摘要】：目的：对单操作孔胸腔镜和3孔胸腔镜治疗自发性气胸作前瞻性对照研究，了解单操作孔胸腔镜的临床应用价值。方法：收集2010年1月至2013年1月间的自发性气胸病人50例，利用单双数抽签法将病人分为两组，电脑随机分配数字，奇数归为单操作孔治疗组，而偶数则归为3孔治疗组。为了避免年龄偏差对研究的影响，我们选择了16至55岁之间的病人；并排除了术前检查为多发性肺大泡患者。数据采用医学统计软件PEMS3.1处理，计量资料采用t检验，计数资料采用卡方检验。结果：两组患者术中麻醉都比较满意；单操作孔与传统标准胸腔镜组相比，手术由于少了一个操作孔，切口总长度明显缩短（P=0.0001）；两组在术中出血量上无明显显统计学意义（P=0.5932）；术后引流量上，单操作孔治疗组均数为308.8±87.10ml，3孔治疗组均数为401.6±118.35ml，具有明显统计学差异（P=0.0027），具体原因可能是多一个操作孔引起胸壁渗出增多。术后疼痛调查，在伴有明显疼痛、微痛伤口麻木者的总数上，单操作孔治疗组明显少于3孔治疗组（P=0.0039），说明在对胸壁的影响方面，单操作孔优于3孔胸腔镜，有统计学意义。其他术后指标在手术时间、住院时间等方面两者无明显区别。结论：单操作孔胸腔镜可以取得与3孔胸腔镜一样的手术效果，而且更微创，，能够提高患者的术后生活质量。
[Abstract]:Objective: to study the clinical value of single-hole thoracoscopy and 3-hole thoracoscopy in the treatment of spontaneous pneumothorax. Methods: 50 patients with spontaneous pneumothorax from January 2010 to January 2013 were divided into two groups by single and even drawing lots. To avoid the effect of age bias on the study, we selected patients between 16 and 55 years of age and excluded preoperative examinations of multiple alveoli. The data were processed by PEMS3.1, t-test was used for metrological data, and chi-square test was used for counting data. Results: the anesthesia was satisfactory in both groups, the single operating hole was one less than that in the traditional standard thoracoscopic group. The total length of incision was significantly shortened by 0.0001m, there was no significant difference in blood loss during operation between the two groups, and there was no significant difference in the volume of bleeding between the two groups. The mean value of single hole treatment group was 308.8 卤87.10 ml / ml, the mean value of the treatment group was 401.6 卤118.35 ml, there was significant difference between the two groups. The specific reason might be that more than one operating hole could cause the increase of chest wall exudation. In the total number of patients with obvious pain and numbness, the single hole treatment group was significantly less than 3 hole treatment group (P 0. 0039), which indicated that the single operation hole was superior to 3 hole thoracoscopy in the influence of chest wall. There was no significant difference in operative time and hospital stay between the two groups. Conclusion: single-hole thoracoscopy can achieve the same effect as 3-hole thoracoscopy, and it is more minimally invasive and can improve the postoperative quality of life of the patients.
【学位授予单位】：延安大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R655

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