非损伤肌肉小切口开胸肺切除术治疗肺疾病的体会

Experience of small incision for pneumonectomy

目的评价改进后的非损伤肌肉小切口肺切除术在肺疾病外科治疗中的作用和地位。方法回顾分析改良非损伤肌肉小切口开胸肺切除术22例的临床资料。结果22例全部在改良非损伤肌肉小切口下完成手术,皮肤切口长度10-15cm,平均13.6厘米;手术时间75-225 min,平均148分钟;术中出血量100-500ml,平均245毫升,术中早期发生1例肋骨骨折。术后除1例老年肺减容术病人发生肺部感染,经呼吸机支持治疗2周后好转外,余21例无一例发生血胸、肺部感染和支气管胸膜瘘等并发症,术后疼痛较常规开胸肺切除术明显减轻,止痛药物用量明显减少,术后全部顺利恢复正常出院。结论改良非损伤肌肉小切口开胸肺切除术,具有创伤小、手术和麻醉时间短、术后疼痛轻、恢复快、肺功能和上肢功能受损伤小等特点,值得在肺外科临床中进一步推广应用。

Objective To evaluate the effect of small incision for pneumonectomy in pneumopathy surgery. Method 22 patients were operated with small incision method for pneumonectomy. Results The average length of skin incision was 13.6 cm. The average duration of operation and blood loss were 148 minutes and 245 ml, respectively. All the patients were completely healed. Conclusions The small incision method for pneumonectomy shows dominances in trama, heal, and operation and anesthesia time.