腋下单孔电视胸腔镜手术治疗自发性血气胸

发布时间：2018-12-26 12:42

【摘要】：目的探讨腋下单孔电视胸腔镜手术(video-assisted thoracoscopic surgery,VATS)治疗自发性血气胸的可行性和疗效。方法 2011年2月~2015年9月对15例自发性血气胸施行腋下单孔VATS,采用双腔气管插管全麻后健侧卧位,腋下垫枕,于腋下腋中、前线间的第3或4肋间做2~3 cm切口。单肺通气,使用5 mm或10 mm 30°胸腔镜探查,吸引器、卵圆钳清除血凝块,行肺大疱结扎或缝扎,胸膜摩擦固定术。结果 15例均在腋下单孔完成VATS,手术时间15~40 min,平均25 min。术中出血10~100 ml,平均30 ml。清除血凝块及积血500~3000 ml,平均1260 ml。术后住院时间3~8 d,平均5 d。15例随访1~48个月,平均24个月,均无复发。结论腋下单孔VATS治疗自发性血气胸切实可行,简单快捷,疗效可靠,经济实用,创伤小,切口美观隐蔽,值得推广。
[Abstract]:Objective to investigate the feasibility and efficacy of single-hole thoracoscopic surgery (video-assisted thoracoscopic surgery,VATS) in the treatment of spontaneous hemopneumothorax. Methods from February 2011 to September 2015, 15 cases of spontaneous hemopneumothorax were treated with single hole VATS, under axillary anesthesia. After general anesthesia with double lumen endotracheal intubation, the supra-axillary pillow was placed in the lateral position, and the third or fourth intercostal incision was performed in the axillary, and the third or fourth intercostal incision was performed in the front line. Single lung ventilation was performed with 5 mm or 10 mm 30 掳thoracoscopic exploration, suction apparatus, oval forceps to remove blood clots, pulmonary bullae ligation or suture, pleural friction fixation. Results all the 15 cases underwent VATS, under axillary single hole for 1540 min, and the average time was 25 min.. Intraoperative bleeding of 10 ~ 100 ml, averaged 30 ml. Clearance of blood clots and hemorrhage at 3000 ml, mean 1260 ml. The average hospitalization time was 5 d.15 months (mean 24 months, 1 ~ 48 months), and no recurrence occurred. Conclusion the treatment of spontaneous hemopneumothorax by single hole VATS under axilla is feasible, simple, quick, reliable, economical and practical, with small trauma, beautiful and concealed incision, and is worth popularizing.
【作者单位】：深圳市第六人民医院广东医学院附属南山医院心胸外科;
【分类号】：R655

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