电视胸腔镜在胸部穿透伤中的应用价值

Value of Video-assisted Thoracoscope in Chest Penetrating Injury

【目的】探讨电视胸腔镜手术（VATS）在胸部穿透性损伤中的应用价值。【方法】对本院35例胸部穿透伤患者，在电视胸腔镜下进行肺和膈肌修补，止血或辅助小切口手术。【结果】全组35例，存在肺裂伤、膈肌破裂、肋间血管损伤、心包裂伤、乳内血管损伤、穿透性胸腹联合伤。单纯胸腔镜手术19例，辅助小切口完成手术16例，手术时间15～160min，随访3～12个月，无与外伤相关的并发症发生。【结论】VATs诊治胸部穿透性损伤准确、及时、微创，适当辅助胸壁小切口可扩大手术适应证。

[Objective]To explore the application value of video-assisted thoraeoseope （VATS） in chest penetrating injury. [Methods]Thirty five cases of chest penetrating injury in our hospital were treated under VATS. Some operations such as lung and diaphragmatic repair, hemostasis, auxiliary small incision operation were performed through VATS. [Results]All 35 patients included lung laceration, diaphragmatic rupture, rib and breast vascular injury, pericardial laceration and thoraco-abdominal penetrating joint injury. Nineteen patients underwent simple VATS operations and 16 patients underwent auxiliary small incision operations under VATS. The operation time was 15-160 minutes and there was no any complication associated with injury by follow-up of 3- 12 months. [Conclusion] VATS for the diagnosis of chest penetrating injury is accurate, prompt and minimally invasive. VATS combined with appropriate auxiliary chest wall small incision can enlarge the indications of surgery.