胸外科两种手术方式对老年患者术后心肺并发症分析

目的:比较65岁以上老年患者行电视胸腔镜手术(VATS)和传统开胸手术后心、肺并发症的发生情况。方法:将776例行胸外科手术的高龄患者根据手术方式不同分为VATS组和传统开胸组。VATS组140例,平均年龄75.2岁;传统开胸组636例,平均年龄73.1岁,(P>0.05)。结果:VATS组手术后心肺并发症总发生率18.6%,传统开胸组31.5%(P<0.05)。VATS组术后肺部并发症发生率61.5%,传统开胸组68.0%(P>0.05)。术后两组心脏并发症总发生率47.8%,肺并发症总发生率67.3%(P<0.01)。结论:因胸部疾患行胸外科手术的高龄患者,VATS组术后心肺并发症的总发生率明显低于传统开胸组。全组术后肺部并发症发生率明显高于心脏并发症。因此,为了手术安全,对高龄患者应提倡采用创伤小的VATS,以减少术后心肺并发症的发生。

Objective：To compare and analyse the postoperative cardiovascular complications and the lung complications in the elder patients over 65 years old who underwent the video assisted thoracic surgery （VATS） and the traditional thoracotomy. Methods： 776 elder patients were divided into two groups：140 patients in the VATS group, the mean age was 75.2 ± 2. 5, the others in the traditional thoracotomy group,636 cases, the mean age was 73.1 ±2.9（P 〈0.05）. Resuits： Post - operative cardio - pulmonary complications of VATS group overall incidence of 18. 6%, traditional open - chest group 31.5% （ P 〈 0. 05 ）. VATS group the incidence of postoperative pulmonary complications, 61.5%, 68. 0% of traditional open - chest group （ P 〉 0. 05 ）. Postoperative cardiac complications in the two groups overall incidence 47. 8% ,lung 67. 3% overall incidence of complications （ P 〈 0. 01 ）. Conclusion：The morbidity of the postoperative complications in the elder patients who underwent VATS was obviously lower than that in the patients who underwent the traditional thoracotomy. So VATS is a safer operation for the elder patients.