双孔法全胸腔镜肺叶切除术治疗肺良性疾病192例分析

发布时间：2018-03-17 18:18

本文选题：双孔法胸腔镜手术　切入点：肺叶切除术　出处：《中国微创外科杂志》2017年06期 　论文类型：期刊论文

【摘要】：目的探讨双孔法全胸腔镜肺叶切除术治疗肺良性疾病的安全性和有效性。方法 2011年2月~2015年10月我科采用双孔法全胸腔镜肺叶切除手术治疗肺良性疾病192例,切口为一个操作孔和一个观察孔,观察孔替代操作孔,应用双关节手术器械双孔双手同向双交叉操作,不撑开或牵拉肋骨,进行解剖性肺叶切除。结果 7例(3.6%)因为胸腔内粘连重,叶间裂分化差或肺门血管迂曲生长出血改为传统三孔法VATS。手术时间(115.6±87.1)min(86~281 min),术中出血量(184.3±71.8)ml(50~374 ml)。术后胸腔引流管放置时间(6.1±4.8)d(2~15 d)。术后住院(9.3±4.6)d(5~16 d)。无围手术期死亡,20例术后并发症(10.4%):术后肺持续漏气12例,肺部感染5例,切口感染3例,均经保守治疗治愈。192例随访平均22.3月(3~40个月),均恢复良好。结论双孔法全胸腔镜肺叶切除术是治疗肺良性疾病的一种安全有效的方法。
[Abstract]:Objective to investigate the safety and efficacy of double hole total thoracoscopic lobectomy in the treatment of benign pulmonary diseases. Methods from February 2011 to October 2015, 192 cases of benign lung diseases were treated by double hole total thoracoscopic lobectomy. The incision consists of an operating hole and an observation hole, and the observation hole replaces the operating hole. The double hole and the double hole are used to operate in the same direction and double cross with each other, so that the ribs are not extended or pulled. Anatomical lobectomy was performed. Results 7 cases had 3. 6% intrathoracic adhesion. The time of operation was 115.6 卤87.1 min ~ 86 ~ 281 min, and the amount of intraoperative bleeding was 184.3 卤71.8 ml ~ 50 ~ 374 ml / min. The time of placement of thoracic drainage tube was 6.1 卤4.8 d ~ 215 d. Postoperative hospitalization was 9.3 卤4.6 d ~ (-1) ~ 516 d ~ (-1). No perioperative death occurred in 20 cases. 10. 4% of the symptoms: there were 12 cases of persistent air leakage in the lungs after operation. There were 5 cases of pulmonary infection and 3 cases of incision infection. All of them were cured by conservative treatment. 192 cases were followed up for an average of 22.3 months or 40 months, all of them recovered well. Conclusion Two-hole total thoracoscopic lobectomy is a safe and effective method for the treatment of benign lung diseases.
【作者单位】：中山大学附属佛山医院广东省佛山市第一人民医院胸外科;
【分类号】：R655.3

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