胸腔镜手术治疗自发性气胸的临床疗效及安全性观察

辛向兵1 ，辛涛2 ，王涛1，李岩1 ，朱爱林1，刘勇世1

（第四军医大学唐都医院：1.胸外科；2.呼吸科，陕西 西安，710038）

浏览次数：90次 下载次数：361次

摘要：

目的 评价胸腔镜手术治疗自发性气胸的临床疗效和安全性。方法 选取我院收治的60例自发性气胸患者为研究对象， 随机将其分为观察组和对照组，每组30例。观察组患者给予胸腔镜手术治疗，对照组患者给予常规手术治疗，观察并比较两组患者的临床疗效、手术时间、拔管时间、住院时间、术中出血量及术后并发症发生情况。结果 治疗后，观察组患者的总有效率为90.00%，显著高于对照组的66.67%，差异有统计学意义（P<0.05）。观察组患者的手术时间、拔管时间、住院时间及术中出血量均显著优于对照组患者，差异有统计学意义（P<0.01）。两组患者的漏气、气胸复发等并发症发生率比较，差异均无统 计学意义（P>0.05）。结论 胸腔镜手术治疗自发性气胸的临床疗效优于常规手术疗法，建议临床推广。

关键词：自发性气胸；胸腔镜手术；气胸复发

中图分类号：R655文献标志码：A文章编号：2096-1413(2017)27-0049-02

Clinical effect and safety of thoracoscopic surgery for treating spontaneous pneumothorax
XIN Xiang-bing 1, XIN Tao 2, WANG Tao 1, LI Yan 1, ZHU Ai-lin 1, LIU Yong-shi 1
(1. Department of Thoracic Surgery; 2. Department of Respiratory, Tangdu Hospital of the Fourth Military
Medical University, Xi``an 710038, China)

ABSTRACT: Objective To evaluate the clinical effect and safety of thoracoscopic surgery for treating spontaneous pneumothorax. Methods Sixty cases of spontaneous pneumothorax patients admitted in our hospital were enrolled as the study objects, and randomly divided into observation group and control group, with 30 cases in each group. The patients in the observation group were given thoracoscopic surgery, while the patients in the control group received open chest surgery. The clinical effect, operation time, extubation time, hospital stays, blood loss during the surgery, and complications after surgery were observed and compared between the two groups. Results After treatment, the total effective rate of the observation group was 90.00%, which was significantly higher than 66.67% of the control gruop, the difference was statistically significant (P<0.05). The operation time, extubation time, hospital stays and blood loss during the surgery in the observation group were significantly better than those in the control group (P<0.01). There was no significant differences in the incidence rate of leakage and pneumothorax recurrence and other complications between the two groups (P>0.05). Conclusion Thoracoscopic surgery has superior effect to open chest surgery in the treatment of spontaneous pneumothorax, which should be applied in clinic.
KEYWORDS: spontaneous pneumothorax; thoracoscopic surgery; pneumothorax recurrence

参考文献：
[1] 文永安,齐光华,陈世柱,等.双孔胸腔镜手术在自发性气胸治疗中应用[J].西藏医药,2016,42(4):32-33.
[2] 王辉,郑翔,闻作川,等.胸腔镜手术治疗自发性性气胸的临床价值 [J].河北医药,2014,36(13):1985-1986.
[3] 周成.应用胸腔镜手术治疗自发性气胸的疗效观察[J].当代医药论丛,2014,4(9):265-266.
[4] 李钢,甘崇志,罗青松,等.单孔法与双孔法胸腔镜肺大疱切除术治疗自发性气胸的对比研究[J].中国微创外科杂志,2016,16(11):961-964.
[5] 陈立军,陈艰,刘志芳,等.电视胸腔镜手术治疗自发性气胸的临床分析[J].实用临床医学,2010,11(3):66-67,69.
[6] 蔡星三.自发性气胸电视胸腔镜手术治疗的麻醉处理分析[J].中国医药指南,2016,14(22):173-174.
[7] 吴正国,蔡庆勇.胸腔镜手术与剖胸手术治疗自发性气胸比较的系统评价[J].现代临床医学,2014,40(1):22-25.