【摘要】 目的 探讨肺心病合并自发性气胸患者行胸腔镜手术治疗的可行性。方法 将我院同期治疗的肺心病合并自发性气胸患者分两组：第1组(仅行胸腔闭式引流)34例，第2组(行胸腔镜手术)22例。对比研究两组患者术后心肺功能及复发情况。结果 各组无术后死亡；第1组心律失常2例，无呼吸衰竭，出院后13例复发，复发率38.2%；第2组心率失常4例，呼吸衰竭2例，出院后无复发，复发率0。结论 对不吸氧情况下血气分析PaO2>60mmHg、PaCO2<50mmHg， 且发病前轻度活动无明显心悸、气喘患者，适合于行胸腔镜手术，但需注意监测术后心肺功能。

    【关键词】 胸腔镜手术；肺心病；气胸

    【Abstract】 Objective To investigate the possibility of video-assisted thoracoscopic surgical (VATS) treatment in patients of pulmonary heart disease， complicated with spontaneous pneumothorax.Methods This study included patients of pulmonary heart disease， complicated with spontaneous pneumothorax who were treated at Beijing Tong Ren hospital during a two-year period. And they were divided into 2 groups: Group 1，34 patients (experiencing closed drainage of pleural cavity).Group 2，22 patients (experiencing VATS).Patients in Group 1 were in comparison with ones in Group 2 in both occurrence of respiratory failure and arrhythmia and recurrence of pneumothorax.Results There was no one dead in all patients.In Group 1 ......