胸腔镜肺大疱手术在早期自发性气胸中的优势研究——42例临床病例对照分析

The Advantage of Video Assisted Thoracoscopic Bullectomy Surgery in Early Spontaneous Pneutfaorax

目的:比较肺大疱破裂致自发性气胸急诊手术治疗和择期手术治疗的优劣,从而探讨推广有选择的自发性气胸急诊手术治疗的可行性及意义。方法:随机抽取的两组病例,共42例。在年龄,性别,病情轻重方面齐同。早期手术组于入院24小时内进行手术治疗,对照组经过充分引流观察,3-7d内手术治疗。两组均行胸腔镜肺大疱切除及胸膜固定术。比较两组手术时间、粘连情况、术后感染、漏气等并发症。结果:两组手术时间、粘连及胸水出现、术后总并发症率、术后拔管时间等均有统计学显著差异(P均<0.05)。结论:肺大疱合并自发性气胸早期行胸腔镜手术治疗手术难度较小,术后近期并发症较少。

(Department of General Surgery,Beijing Puren Hospital, Beijing 100062,China) Objective: To study and compare the advantage of emergency operation and selective surgery for spontaneous pneutho-rax, followed repture of pulmonary bulk, thus populize the possibilities of emergency operation for spontancoud pneuthorax. Methods: 42 patients are divided into 2 groups randomly, with similar age, gender, as well as seriousity. The first group, surgical procedure were performed within 24 hours, admission for early operation group; chest drainage thoroughly and observation were made for control group, then went through operation within 3 to 7 days.Both come up with Bullectomy and Pleurodosis. Study the operation duration, adhension, postoperation infection, airleakage. Results: Significant diffrence stastically (P < 0.05) shown among operation duration, adhension and postoperational complications as well as removal time of chest tube.Conclusion: Early VATS operation for pulmonary bulk with spontaneous pneuthorax is less difficalt, meanwhile less early stage complications.