电视胸腔镜手术治疗自发性气胸临床疗效分析(1)
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[摘要] 目的：探讨临床电视胸腔镜辅助下小切口(VAMT)手术对于自发性气胸患者的临床治疗效果。方法：将72例需要接受手术治疗的临床自发性气胸患者随机分成常规组及腔镜组, 两组患者均在直视条件下进行肺大疱的结扎术或切除术或胸膜固定术，其中腔镜组在电视胸腔镜的辅助之下对患者胸大肌外侧缘以及背阔肌外侧缘之间做一长4～6 cm的小切口；对常规组患者行患侧的胸前外侧切口，对两组患者手术切口的长度、手术所需时间、胸管的留置时间以及住院天数等临床各项相关性指标进行比较分析。结果：腔镜组患者其手术切口的长度、住院时间以及术后胸管的留置时间相对常规组患者而言均有所缩短(P<0.05)，并且腔镜组的患者在手术之后未发生明显的临床并发症。结论：相对于传统的前外侧开胸切口手术而言，VAMT手术对于自发性气胸患者的治疗创伤较小，恢复快,术后并发症少，效果明显，值得临床借鉴应用。
[关键词] 电视胸腔镜；小切口；自发性气胸；外科治疗
[中图分类号] R541.4 [文献标识码] A [文章编号] 1673-7210(2011)07(a)-053-02
Clinical analysis of video-assisted thoracoscope surgery to treat the spontaneous pneumothorax
LIU Chengjun
Department of Thoracic Surgury, the Second Hospital of Hengshui City, Hebei Province, Hengshui 053000, China
[Abstract] Objective: To explore the clinical efficacy of the spontaneous pneumothorax with the aid of video-assisted mini thoracotomy (VAMT). Methods: 72 patients required surgical therapy for spontaneous pneumothorax were randomly divided into normal group and the laparoscopy group, both groups were under the conditions of the ligation of lung bullae or resection or pleurodesis with direct vision, laparoscopy group were made a small incision about 4-6 cm between the lateral margin of pectoralis major and latissimus dorsi muscle under VAMT; the normal group were made the incision in ipsilateral anterolateral incision, the length of incision, operative time, chest tube indwelling time, number of days of hospitalization and other relevant clinical indicators were analyzed in both groups. Results: The patients in laparoscopy group had the shorter with the length of incision, hospital stay and postoperative chest tube indwelling time for patients compared with the normal group (P<0.05), and the patients in laparoscopy group had no obvious clinical complications after surgery. Conclusion: VAMT for the spontaneous pneumothorax with the less trauma and the faster recovery compared with the traditional anterolateral thoracotomy incision has less clinical complications after operation, and has obvious effect, which is worthy of clinical use.
[Key words] VATS; Mini incision; Spontaneous pneumothorax; Surgical treatment ......
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