摘要
目的比较剑突下单孔电视辅助胸腔镜和肋间单孔电视辅助胸腔镜两种手术方法切除双侧肺大泡的临床效果及安全性。方法2014年9月~2019年9月我院胸心外科收治的双侧肺大泡病人320例,随机数表法分为剑突下组和肋间组,每组各160例;剑突下组给予剑突下单孔电视辅助胸腔镜手术方式,肋间组给予肋间单孔电视辅助胸腔镜手术方式,随访3个月,观察两组病人手术、住院及并发症情况。结果剑突下组病人术中出血量及总出血量、手术时间、保留引流管时间、住院时间均少于肋间组,两组比较差异有统计学意义(P<0.05)。剑突下组病人术后即刻、2小时、12小时及24小时VAS评分和舒适度评分均低于肋间组,两组比较差异有统计学意义(P<0.05)。两组均无因胸腔镜手术发生引起死亡的病例,剑突下组并发症发生率低于肋间组,差异有统计学意义(P<0.05)。结论剑突下单孔电视辅助胸腔镜手术治疗双侧肺大泡较传统肋间单孔电视辅助胸腔镜具有出血量少、疼痛减轻、增加舒适度及减少并发症发生率的优势。
Objective To compare the clinical effect and safety of subxiphoid single-pore video-assisted thoracoscopy and intercostal single-pore video-assisted thoracoscopy in the treatment of bilateral bullae.Methods 320 patients with bilateral pulmonary bulbar admitted to the department of thoracic and cardiac surgery of the air force hospital of the western theater command from September 2014 to September 2019 were selected.All cases were divided into subxiphoid group and intercostal group according to the random number table,160 cases each.In the subxiphoid group,video-assisted thoracoscopy was performed with single hole of subxiphoid.The intercostal group was treated with video-assisted thoracoscopic surgery with single intercostal foramina,followed up for 3 months,and the operation,hospitalization and complications of the patients in the two groups were observed.Results There was significant difference in the intraoperative blood loss,total blood loss,operation time,drainage tube retention time and hospitalization time of the patients between the subxiphid process group and the intercostal group(P<0.05).The VAS score and comfort score of patients in the subxiphoid group were significantly better than those in the intercostal group,and the difference was statistically significant(P<0.05).There were no death complications caused by thoracoscopic surgery in the two groups,and the incidence of complications in the subxiphoid group was significantly lower than that in the intercostal group,with a statistically significant difference(P<0.05).Conclusion Compared with traditional intercostal single-hole video-assisted thoracoscopy,single hole video-assisted thoracoscopy under xiphoid has the advantages of less bleeding,less pain,more comfort and less complication rate,which is safe and reliable and worthy of clinical promotion and application.
作者
魏秀波
王晓栋
WEI Xiubo;WANG Xiaodong(Department of Thoracic and Cardiac Surgery,Air Force Hospital of Western Theater Command,Chengdu 610000,China)
出处
《临床外科杂志》
2021年第6期530-533,共4页
Journal of Clinical Surgery
关键词
肺大泡
双侧
胸腔镜
疼痛视觉模拟评分
pulmonary bullae
on both sides
thoracoscope
visual analogue score for pain
