双侧肺大疱同期胸腔镜外科治疗临床分析

发布时间：2018-08-30 20:46

【摘要】：目的：探讨胸腔镜同期治疗对侧肺大疱的疗效。方法：回顾分析新疆医科大学第一附属医院2011年3月至2013年4月所有行手术治疗的160例肺大疱患者的临床资料,根据肺大疱所在部位及手术部位分为A、B、C三组。A组：108例自发性气胸患者无对侧肺大疱而接受单侧胸腔镜肺大疱切除术；B组：40例自发性气胸患者有双侧肺大疱,但只接受单侧胸腔镜肺大疱切除术；C组：12例自发性气胸患者患双侧肺大疱,同期行双侧胸腔镜肺大疱切除术。分析三组患者对侧气胸发生率及急性肺水肿、胸腔粘连、呼吸衰竭、术后肺漏气等并发症的发生率。结果：随访20个月,A组：术后发生急性肺水肿1例(0.9%),胸腔粘连11例(10.19%),呼吸衰竭2例(1.86%),术后漏气5例(4.62%)。随访期间对侧发生自发性气胸3例(2.78%)。B组：术后发生胸腔粘连4例(10.00%),呼吸衰竭1例(2.50%),术后漏气3例(7.50%)。对侧发生自发性气胸15例(37.50%)。C组：术后发生胸腔粘连2例(16.67%),术后漏气1例(8.33%)。随访期间无对侧自发性气胸的发生。结论：同期电视胸腔镜手术预防性治疗对侧肺大疱,疗效满意,安全可靠,能有效预防对侧气胸的发生。
[Abstract]:Objective: to evaluate the efficacy of thoracoscopic treatment of contralateral pulmonary bullae. Methods: the clinical data of 160 patients with pulmonary bullae treated in the first affiliated Hospital of Xinjiang Medical University from March 2011 to April 2013 were retrospectively analyzed. According to the location of pulmonary bullae and the site of operation, group A was divided into group A (n = 108) and group A (n = 108) without contralateral pneumothorax. Group B (n = 40) received unilateral thoracoscopic pneumonectomy and group B (n = 40) had bilateral pulmonary bullous pneumothorax. But only unilateral thoracoscopic pneumonectomy was performed in group C: 12 patients with spontaneous pneumothorax suffered from bilateral bullous pneumothorax and bilateral thoracoscopic bullous pneumonectomy was performed at the same time. The incidence of contralateral pneumothorax, acute pulmonary edema, thoracic adhesion, respiratory failure and postoperative lung leakage were analyzed. Results: in group A, acute pulmonary edema occurred in 1 case (0.9%), thoracic adhesion in 11 cases (10.19%), respiratory failure in 2 cases (1.86%) and air leakage in 5 cases (4.62%). Spontaneous pneumothorax occurred in 3 cases (2.78%) in the contralateral pneumothorax. Group B: thoracic adhesion occurred in 4 cases (10.00%), respiratory failure in 1 case (2.50%), and postoperative air leakage in 3 cases (7.50%). There were 15 cases (37.50%) with spontaneous pneumothorax on the contralateral side. In group C, thoracic adhesion occurred in 2 cases (16.67%) and air leakage in 1 case (8.33%). There was no contralateral spontaneous pneumothorax during follow-up. Conclusion: the prophylactic treatment of contralateral pulmonary bullae by video-assisted thoracoscopic surgery is satisfactory, safe and reliable, and can effectively prevent the occurrence of contralateral pneumothorax.
【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R655.3

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