摘要
目的：比较电视胸腔镜与常规开胸手术在治疗老年脓胸患者中的临床效果。方法选择120例术前判断为II期（纤维素期）脓胸的老年患者，其中81例行电视胸腔镜手术，39例行常规开胸手术，比较两组手术时间、出血量、术后引流管放置时间、引流量、疼痛程度、术后住院时间及术后近期并发症发生率。结果电视胸腔镜组手术时间、术中出血量、术后胸腔引流管放置时间、引流量、术后住院时间、疼痛评分及术后呼吸道并发症与开胸手术组相比，均有统计学差异（P〈0.05）。63例（77.78％）完成胸腔镜手术，14例（17.28％）辅助小切口手术，4例（4.93％）行中转开胸手术。两组均无手术死亡及严重并发症，随访均无复发病例。结论与常规开胸手术相比，电视胸腔镜手术或辅助小切口治疗老年脓胸，能达到清除病因、闭合脓腔、恢复肺功能的目的，对老年脓胸患者心肺功能影响小，是治疗老年脓胸的最优选择。
Objective To compare the efficacy between video-assisted thoracic surgery （VATS） and conventional thoracotomy in elderly patients with early-stage empyema. Methods A total of 120 elderly patients diagnosed with stage II（cellulose stage）empyema,who underwent VATS（n=81）or conventional thoracotomy （n=39）,were included in the study. The operation time,blood loss,postoperative thoracic drainage duration, drainage volume, pain, postoperative hospital stay and incidence of recently postoperative complications between the two groups were compared. Results There were statistical differences in the operation time,intraoperative blood loss,postoperative thoracic drainage duration, drainage volume,postoperative hospital stay,pain score and postoperative respiratory tract complications between the VATS group and the conventional thoracotomy group（P〈0.05）. In the VATS group,63 cases （77.78%） underwent VATS,14 （17.28%） underwent video-assisted minithoracotomy （VAMT）,and 4 （4.93%）were converted to thoracotomy. No surgical death,severe complications,and recurrent cases during the follow-up were found in both groups. Conclusion Compared with the conventional thoracotomy,VATS or VAMT is the optimal choice for the treatment of empyema in elderly patients,providing lesion clearance, abscess cavity closure,pulmonary function recovery,and less impacts on cardiopulmonary function in elderly patients with empyema.
出处
《中华生物医学工程杂志》
CAS
2015年第2期170-173,共4页
Chinese Journal of Biomedical Engineering
基金
广东省科技计划项目（20118080701031）
关键词
电视胸腔镜
常规开胸手术
老年脓胸
Video-assisted thoracic surgery
Conventional thoracotomy
Elderly empyema
