摘要
目的探讨在治疗单侧自发性气胸时预防性处理对侧肺大泡的临床疗效。方法选取重庆医科大学附属第二医院胸心外科2013年6月至2016年6月收治的单侧自发性气胸患者116例,按照肺大泡生长部位和处理方式的不同分为A(n=40)、B(n=40)、C(n=36)三组。A组患者单侧气胸,患侧出现肺大泡,行患侧肺大泡切除术;B组患者单侧气胸,双侧出现肺大泡,行患侧肺大泡切除术;C组患者单侧气胸,双侧出现肺大泡,行双侧肺大泡切除术。分析三组患者的术中术后情况及对侧气胸复发率。结果三组患者均顺利完成手术,且三组在年龄、性别、是否抽烟、体重指数评分、术中出血量、术后拔管时间、术后住院时间、术后疼痛评分上比较,差异均无统计学意义(P>0.05)。与A、B组比较,C组手术时间更长、费用更高,差异均有统计学有意义(P<0.01)。随访期间,A、B组出现对侧气胸发作,两组气胸复发率比较,差异有统计学意义(P<0.05),而C组未见气胸复发。结论预防性处理对侧肺大泡有益于单侧自发性气胸的治疗。在患者心理生理耐受基础上可建议其选择预防性对侧肺大泡切除手术。
Objective To investigate the clinical effect of prophylactic treatment of side lung blisters in the treatment of unilateral spontaneous pneumothorax. Methods Selected 116 patients who received by the department of cardiothoracic surgery in the Second Affiliated Hospital of Chongqing Medical University from June 2013 to June 2016, they were divided into A（n=40）, B （n=40）and C groups （n=36） according to the different growth parts and treatment methods of the lung. In group A, each patient had a large puhnonary vesicle on the side with unilateral pneumothorax, performed lateral pneumonectomy. In group B, each patient had both sides of the lung bullae with unilateral pneumothorax, performed lateral pneumonectomy. In group C, each patient had both sides of the lung bullae with unilateral pneumothorax, performed bilateral puhnonary alveolecto- my. The postoperative condition and the recurrence rate of lateral pneumothorax of the patients were analyzed in three groups. Results All patients in three groups successfully completed the operation. The patients in three groups were compared in age, sex, smoking, body mass index, intraoperative blood loss, postoperative time, postoperative hospital stay, and postoperative pain score, there were no significant difference （P〉0.05）. Compared with group A and B, the operation time of patients in group C was longer and higher, and the difference was statistically significant （P〈0.01）. During the follow-up period, the patients in A and B group showed bilateral pneumothorax attacks, and the difference between the two groups was statistically significant （P〈 0.05）. No recurrence of pneumothorax of the patients in group C were seen. Conclusion It is beneficial to treat unilateral pneumothorax in the treatment of unilateral pneumothorax. On the basis of the patient＇ s physiological and physiological toler-ance, it can be suggested to choose a preventive treatment of the side lung mastectomy.
作者
罗程文
邹赢波
谭媛
汪天虎
Chengwen;ZO U Yingbo;TAN Yuan;WANG Tianhu(Department of cardiothoracic surgery,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China;Department of cardiothoracic surgery,the Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China)
出处
《现代医药卫生》
2018年第13期1983-1985,共3页
Journal of Modern Medicine & Health
关键词
肺
气胸/治疗
胸腔镜检查
肺大泡
预防性
切除术
Lung
Pneumothorax/therapy
Thoracoscopy
Pulmonary bullae
Preventive
Excision
