电视胸腔镜诊治外伤性机化性血胸的体会

Video-assisted thoracoscopic surgery for traumatic euplastic hemothorax

目的探讨外伤性机化性血胸的病因、手术适应证及电视胸腔镜手术(VATS)和电视胸腔镜小切口(VAM T)手术在诊治中的作用。方法回顾总结28例因外伤导致的机化性血胸的病因以及胸腔镜治疗的手术方法和疗效。VATS二孔凝血块碎吸15例,VAM T手术血胸廓清加纤维板剥脱13例;双侧同期手术4例。结果VATS平均时间30 m in,VAM T手术时间平均55m in,胸腔引流时间平均3 d,术后平均住院12 d,无并发症及手术死亡。结论重度复合伤早期处理不当是外伤性机化性血胸的重要病因。电视胸腔镜手术创伤小、出血少、恢复快、疼痛轻,是一种微创有效的治疗方法。

Objective To evaluate the effect of video-assisted thoracoscopic surgery（VATS）and video-assisted minithoracotomy surgery（VAMT）on diagnosis and treatment of traumatic euplastic hemothorax. Methods Retrospective study was conducted on 28 cases of euplastic hemothorax caused by trauma as well as the curative effect of video-assisted thoracoscopic surgery. Results The mean operation time was 30 minites for VATS,55 minites for VAMT,and the mean time of pleural cavity drainage was 3 days. The mean period of hospitalization was 12 days. There was no complication or death in the operation group. Conclusion The important causation of traumatic euplastic hemothorax is unsuitable disposal of severe complex injury in early period. VATS is characteristic of microlesion,less hemorrhage,light pain and prompt recovery. It is a microtraumatic and effective treatment method.