小切口胸腔镜手术治疗肺大泡破裂致自发性气胸的临床疗效观察

Clinical observation of small incision thoracoscopic operation for spontaneous pneumothorax caused by ruptured bulla of lung

目的探究小切口胸腔镜手术治疗肺大泡破裂致自发性气胸的临床疗效。方法选取2016年1月至2021年1月本院收治的102例肺大泡破裂致自发性气胸患者作为研究对象,根据手术方法不同分为参考组与观察组,每组51例。参考组行传统后外侧开胸手术,观察组行小切口胸腔镜手术。比较两组围术期指标(术中出血量、手术时间、住院时间、胸管引流量、胸管放置时间)、血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]水平。结果观察组术中出血量、胸管引流量均少于参考组,手术时间、住院时间、胸管放置时间均短于参考组,差异有统计学意义(P<0.05)。术前,两组PaO_(2)、PaCO_(2)水平比较差异无统计学意义;术后,两组PaO_(2)水平均高于术前,PaCO_(2)水平均低于术前,且观察组PaO_(2)高于参考组,PaCO_(2)低于参考组,差异有统计学意义(P<0.05)。结论小切口胸腔镜手术治疗肺大泡破裂致自发性气胸临床疗效显著,术中出血量较小,利于患者术后身体恢复,可改善患者的肺泡通气状况。

Objective To investigate the clinical effect of small incision thoracoscopic operation for spontaneous pneumothorax caused by ruptured bulla of lung.Methods 102 patients with spontaneous pneumothorax caused by ruptured bulla of lung in our hospital from January 2016 to January 2021 were selected as the research subjects,and they were divided into the reference group and the observation group according to different surgical methods,with 51 cases in each group.The reference group received traditional posterolateral thoracotomy,and the observation group received small incision thoracoscopic surgery.The perioperative indexes(intraoperative blood loss,operation time,hospitalization time,chest tube drainage volume,chest tube placement time)and blood gas index arterial partial pressure of oxygen(PaO_(2))and arterial partial pressure of carbon dioxide(PaCO_(2))levels were compared between the two groups.Results The intraoperative blood loss and chest tube drainage volume of the observation group were less than those of the reference group,and the operation time,hospitalization time,and chest tube placement time were all shorter than those of the reference group,and the difference was statistically significant(P<0.05).Before operation,there was no significant difference in PaO_(2)、PaCO_(2) levels between the two groups;after operation,the PaO_(2) level in the two groups was higher than that before operation,and the PaCO_(2) level was lower than that before the operation,and the PaO_(2) of the observation group was higher than the reference group,and the PaCO_(2) of the observation group was lower than the reference group,the difference was statistically significant(P<0.05).Conclusion The treatment of spontaneous pneumothorax caused by ruptured bulla of lung by thoracoscopic surgery with small incision has significant clinical efficacy and small intraoperative blood loss,which is conducive to postoperative recovery of patients and improvement of alveolar ventilation of patients.