摘要
目的探讨单操作孔胸腔镜与三孔胸腔镜治疗肺大泡的临床效果。方法90例肺大泡并自发性气胸患者,采用随机数字表法分为观察组和对照组,每组45例。对照组采用三孔电视辅助胸腔镜手术(VATS)治疗,观察组行单操作孔VATS治疗。比较两组患者手术相关指标、术后不同时间段疼痛评分、手术前后血气指标。结果两组手术时间、术后胸管引流量、术后胸管放置时间、住院总费用比较差异无统计学意义(P>0.05);观察组术中出血量(5.5±1.4)ml少于对照组的(15.4±2.7)ml,术后住院时间(4.3±1.1)d短于对照组的(6.5±1.3)d,患者对切口的满意度评分(4.5±0.4)分高于对照组的(3.6±0.8)分,差异有统计学意义(P<0.05)。术后6、12、24 h,观察组疼痛评分均明显低于对照组,差异有统计学意义(P<0.05)。手术前,两组动脉血氧分压(PaO2)和动脉血二氧化碳分压(PaCO2)水平比较差异无统计学意义(P>0.05);手术后,观察组PaO2(97.36±5.53)mm Hg(1mm Hg=0.133 kPa)明显高于对照组的(93.00±8.78)mm Hg,PaCO2(38.5±2.3)mm Hg明显低于对照组的(42.1±2.5)mm Hg,差异有统计学意义(P<0.05)。结论单操作孔VATS治疗肺大泡并自发性气胸可明显减少术中出血量、提高切口满意度、缩短住院时间、减轻疼痛和改善血气指标。
Objective To discuss the clinical effect of single-hole and three-hole thoracoscopy in the treatment of pulmonary bullae complicated with spontaneous pneumothorax.Methods A total of 90 patients with pulmonary bullae complicated with spontaneous pneumothorax were divided into observation group and control group according to random number table method,with 45 cases in each group.The control group was treated with three-port video-assisted thoracic surgery(VATS),and the observation group was treated with single-port VATS.The surgical related indicators,postoperative pain scores at different time points and blood gas indexes before and after treatment in two groups were compared. Results There was no statistically significant difference in operationtime, postoperative chest tube drainage volume, postoperative chest tube placement time and total hospitalizationcosts between the two groups (P>0.05). In the observation group, the intraoperative hemorrhage (5.5±1.4) mlwas less than that of the control group (15.4±2.7) ml, the postoperative hospitalization time (4.3±1.1) d wasshorter than that of the control group (6.5±1.3) d, and the patient satisfaction score for incision (4.5±0.4) pointswas higher than that of the control group (3.6±0.8) points. Their difference was statistically significant (P<0.05).At 6, 12 and 24 h after operation, the pain score in the observation group was obviously lower than those of thecontrol group, and the difference was statistically significant (P<0.05). Before operation, there was no statisticallysignificant difference in arterial oxygen partial pressure (PaO2) and arterial carbon dioxide partial pressure (PaCO2)between the two groups (P>0.05). After operation, the PaO2 (97.36±5.53) mm Hg (1mm Hg=0.133 kPa) in theobservation group was obviously higher than that of the control group (93.00±8.78) mm Hg, and the PaCO2(38.5±2.3) mm Hg was obviously lower than that of the control group (42.1±2.5) mm Hg. Their differencewas statistically significant (P<0.05). Conclusion For the treatment of pulmonary bullae complicated withspontaneous pneumothorax, single-port VATS can obviously reduce amount of intraoperative hemorrhage improvetheir satisfaction for incision, shorten hospitalization time, relive pain and improve blood gas indicators.
作者
林立尧
梁柱
程可洛
陈春源
陈林
黄一东
LIN Li-yao;LIANG Zhu;CHENG Ke-luo(Department of Cardio-Thoracic Surgery,Affiliated Hospital of Guangdong Medical University,Zhanjiang 524001,China)
出处
《中国现代药物应用》
2019年第16期8-10,共3页
Chinese Journal of Modern Drug Application
关键词
肺大泡
自发性气胸
单操作孔胸腔镜
三孔胸腔镜
Pulmonary bullae
Spontaneous pneumothorax
Single-hole thoracoscopy
Three-hole thoracoscopy
