单孔法与双孔法胸腔镜肺大疱切除术治疗自发性气胸的对比研究

发布时间：2018-06-21 23:33

本文选题：自发性气胸 + 单孔胸腔镜手术　；参考：《中国微创外科杂志》2016年11期

【摘要】：目的比较单孔法与双孔法胸腔镜肺大疱切除术治疗自发性气胸的疗效。方法回顾性分析我院2013年5月~2014年4月109例单侧自发性气胸的临床资料,其中单孔组59例,双孔组50例,比较2组手术时间、术中出血量、术后总胸腔引流量、术后胸腔引流管留置时间、术后住院时间、并发症发生率、围手术期死亡率和术后疼痛评分。结果 2组均顺利完成手术,无中转开胸及围手术期死亡。2组手术时间无明显差异[(57.7±21.5)min vs.(60.3±26.8)min,t=-0.562,P=0.575];单孔组术中出血量中位数明显少于双孔组(10 ml vs.20 ml,Z=-2.411,P=0.016);单孔组术后总胸腔引流量中位数明显少于双孔组(110 ml vs.312 ml,Z=-5.168,P=0.000);单孔组术后胸腔引流管留置时间明显短于双孔组[(2.8±0.9)d vs.(4.2±2.8)d(t=-3.628,P=0.000];单孔组术后住院时间明显短于双孔组[(3.7±1.1)d vs.(4.7±3.0)d,t=-2.380,P=0.019];单孔组术后NRS法疼痛评分明显小于双孔组[(3.3±1.5)分vs.(4.8±1.6)分,t=-5.046,P=0.000]。2组各发生肺部漏气1例。2组患者术后1、3、6、12个月定期随访,随访12个月,无气胸复发。结论单孔法与常规双孔法胸腔镜肺大疱切除术治疗自发性气胸,疗效相当,在技术上是安全、可行的,单孔法疼痛更轻,恢复更快,更具有微创优势。
[Abstract]:Objective to compare the effect of thoracoscopic bullous excision with one hole method and two-hole method in the treatment of spontaneous pneumothorax. Methods the clinical data of 109 cases of unilateral spontaneous pneumothorax in our hospital from May 2013 to April 2014 were analyzed retrospectively, including 59 cases in single hole group and 50 cases in double hole group. Postoperative thoracic drainage tube indwelling time, postoperative hospitalization time, incidence of complications, perioperative mortality and postoperative pain score. Results the operation was successfully completed in both groups. There was no significant difference in the operative time between the two groups (57.7 卤21.5) min vs. (60.3 卤26.8), the median of intraoperative bleeding in the single hole group was significantly lower than that in the double hole group (10 ml / ml vs.20 / ml ZAL-2.411P 0.016), and the median of postoperative total thoracic drainage volume in the single hole group was significantly lower than that in the double hole group (110ml / ml). The time of intrathoracic drainage in the single hole group was significantly shorter than that in the double hole group [(2.8 卤0.9) d vs. (4.2 卤2.8) d (t ~ (-3.628) P ~ 0.000]; the hospitalization time in the single hole group was significantly shorter than that in the double-hole group [(3.7 卤1.1) d vs. (4.7 卤3.0) days]; the pain score in the single hole group was significantly lower than that in the double-hole group [(3.3 卤1.5) vs (4.8 卤1.6) min vs 0.000]. The postoperative pain scores in the single hole group were significantly lower than those in the double-hole group [(3.3 卤1.5) vs (4.8 卤1.6) min vs 5.046P 0.000]. Pulmonary leakage occurred in 1 case of group 2. 6 cases were followed up regularly for 12 months. No recurrence of pneumothorax was found after 12 months follow-up. Conclusion the treatment of spontaneous pneumothorax with single hole method and double hole thoracoscopic bullous excision is effective, safe and feasible. The single hole method has the advantages of less pain, faster recovery and more minimally invasive.
【作者单位】：四川省医学科学院四川省人民医院胸外科;
【分类号】：R655.3

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