单孔牵引法VATS治疗原发性自发性气胸的临床疗效分析

发布时间：2018-07-08 08:54

本文选题：原发性自发性气胸 + 电视胸腔镜手术　；参考：《延边大学》2017年硕士论文

【摘要】：目的分析单孔牵引法、两孔法和单孔法胸腔镜手术治疗原发性自发性气胸的临床疗效。方法选取我院2014年05月—2016年10月间经胸腔镜手术的原发性自发性气胸226例,根据治疗方法的不同分为两孔法组(166例)、单孔法组(20例)及单孔牵引法组(40例),分析三组平均手术时间、麻醉时间、出血量、术后引流量、带管时间、住院天数、疼痛评分、住院费用和复发率等,比较两孔法、单孔法与单孔牵引法之间是否存在统计学差异性。结果本研究中男性204例,女性22例,男女比例10:1;汉族147例,朝鲜族68例,其他11例,比例为13:6:1;首次发作210例,多次发作16例,比例为14:1;疼痛程度中轻度118例,中度100例,重度8例,比例为15:12:1;所有对象随访期内复发1例,为两孔法组。单孔牵引法手术时间与两孔法比较(42.8±16.2vs37.3±12.5),差异有统计学意义(p0.05),而和单孔法(47.4±11.9)比较差异无统计学意义;单孔牵引法出血量与两孔法比较(20.26±9.44 vs38.51±13.34),差异有统计学意义(p0.05),单孔牵引法出血量与单孔法比较(20.26±9.44 vs 15.52±1.57),差异有统计学意义(p0.05);单孔牵引法疼痛评分与两孔法比较(3.18±1.15 vs3.90±1.45),差异有统计学意义(p0.05),而和单孔法比较(2.95±1.13)比较差异无统计学意义;三组间麻醉时间、术后1日引流量、带管时间、住院天数和住院费用比较差异无统计学意义。结论1.单孔牵引法VATS治疗原发性自发性气胸可以取得与两孔法、单孔法相同的治疗效果。2.单孔牵引法VATS治疗原发性自发性气胸具有安全、可靠及术后疼痛轻的优点,熟练后可缩短手术时间,效果更佳,值得在临床治疗自发性气胸中推广应用。3.牵引辅助法可用于肺肿瘤局部切除、肺活检等更多胸腔镜手术。
[Abstract]:Objective to analyze the clinical effect of single-hole traction, two-hole and one-hole thoracoscopy in the treatment of primary spontaneous pneumothorax. Methods 226 patients with primary spontaneous pneumothorax who underwent thoracoscopic surgery from May 2014 to October 2016 were selected. According to the different treatment methods, the patients were divided into two hole group (166 cases), one hole group (20 cases) and one hole traction group (40 cases). The cost of hospitalization and recurrence rate were compared between the two hole method, single hole method and single hole traction method. Results in this study, 204 males, 22 females, 10: 1 male / female ratio, 147 Han nationality, 68 Korean, 11 others (13: 6: 1), 210 cases of first episode, 16 cases of multiple episodes (14: 1), 118 cases of mild pain, 100 cases of moderate pain, There were 8 severe cases (15: 12: 1) and 1 case of recurrence in all subjects during the follow-up period. The operative time of single-hole traction method was significantly different from that of two-hole method (42.8 卤16.2vs37.3 卤12.5), but there was no significant difference compared with single-hole method (47.4 卤11.9). The amount of bleeding in the single hole traction method was significantly higher than that in the single hole traction method (20.26 卤9.44 vs38.51 卤13.34), and the single hole traction method was significantly higher than the single hole method (20.26 卤9.44 vs 15.52 卤1.57, p0.05), and the pain score of the single-hole traction method was (3.18 卤1.15 vs3.90 卤1.45) compared with that of the two-hole method (p0.05), which was significantly different from that of the single-hole traction method (20.26 卤9.44 vs 15.52 卤1.57) and the single-hole traction method (3.18 卤1.15 vs3.90 卤1.45). There was statistical significance (p0.05), but there was no significant difference compared with single-hole method (2.95 卤1.13). There was no significant difference between the three groups in anesthetic time, postoperative drainage, tube length, hospitalization days and hospitalization expenses. Conclusion 1. The treatment of primary spontaneous pneumothorax with single hole traction method vats can achieve the same effect as that of two hole method and one hole method. The treatment of primary spontaneous pneumothorax by single hole traction method vats has the advantages of safety, reliability and light postoperative pain. It can shorten the operation time after being skilled, and the effect is better. It is worth popularizing and applying in clinical treatment of spontaneous pneumothorax. Traction-assisted surgery can be used for local resection of lung tumors, lung biopsy and more thoracoscopic surgery.
【学位授予单位】：延边大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R561.4

【参考文献】