摘要
目的比较胸腔镜辅助小切口手术与传统开胸手术治疗肺大疱并自发性气胸患者的效果。方法将80例肺大疱并自发性气胸患者根据手术方式不同分为胸腔镜组(行胸腔镜辅助小切口手术)与开胸组(行传统开胸手术),每组40例。比较2组手术一般情况、术后疼痛程度、肺功能指标[第1秒用力呼气容积占预计值百分比(FEV 1%)、每分钟通气量(MV)、用力肺活量(FVC)、肺一氧化碳弥散量(DLCO)]变化及并发症发生情况。结果胸腔镜组手术时间、术中出血量、术后拔管时间、住院时间均显著优于开胸组(P<0.05)。术后1、3、7 d时,胸腔镜组疼痛评分均显著低于开胸组(P<0.05)。术后7 d,2组FEV 1%、FVC、MV、DLCO均较术前显著降低(P<0.05),但胸腔镜组降低程度显著小于开胸组(P<0.05)。胸腔镜组术后并发症发生率为12.50%,显著低于开胸组的37.50%(P<0.05)。结论胸腔镜辅助小切口手术治疗肺大疱并自发性气胸疗效显著,具有术后疼痛轻、恢复快及对肺功能影响小等优势。
Objective To compare effect of thoracoscope-assisted small incision surgery and traditional thoracotomy in the treatment of pulmonary bulla patients complicated with spontaneous pneumothorax.Methods Totally 80 pulmonary bulla patients complicated with spontaneous pneumothorax were divided into thoracoscope group(treated by thoracoscope-assisted small incision surgery)and thoracotomy group(traditional thoracotomy)according to different surgical methods,with 40 cases in each group.The general conditions,postoperative pain,lung function indexes[forced expiratory volume in one second as a percentage of predicted value(FEV 1%),minute ventilation(MV),forced vital capacity(FVC),diffusion capacity for carbon monoxide of lung(DLCO)]and complications were compared between the two groups.Results The operation time,intra-operative blood loss,postoperative extubation time and hospitalization time of thoracoscope group were significantly better than those of thoracotomy group(P<0.05).At 1,3 and 7 days after surgery,pain scores in thoracoscope group were significantly lower than those in thoracotomy group(P<0.05).At 7 days after surgery,FEV 1%,FVC,MV and DLCO in both groups were significantly lower than those before surgery(P<0.05),and the degree of reduction in thoracoscope group was significantly less than that in thoracotomy group(P<0.05).The incidence rate of postoperative complications in thoracoscope group was significantly lower than that in thoracotomy group(12.50%vs.37.50%,P<0.05).The two groups were followed up for 6 months,without recurrence of pneumothorax.Conclusion The thoracoscope-assisted small incision surgery is superior to traditional thoracotomy in treatment of pulmonary bulla patients complicated with spontaneous pneumothorax,which has advantages of mild postoperative pain,quick recovery and few influence on lung function.
作者
林志忠
余伟
庹哲
胡秀华
LIN Zhizhong;YU Wei;TUO Zhe;HU Xiuhua(Yunxi County People′s Hospital,Shiyan,Hubei,442600)
出处
《实用临床医药杂志》
CAS
2020年第1期88-91,共4页
Journal of Clinical Medicine in Practice
关键词
肺大疱
自发性气胸
胸腔镜
开胸手术
肺一氧化碳弥散量
并发症
pulmonary bulln
spontaceont pcenmotOornx
tOoracoscopc
tOoracotomy
diVnsion cdpncity Un coitoa moaoxiVn of lnng
complicatioac
