腹腔镜下小切口肺大疱切除术治疗自发性气胸的临床应用

Clinical application of laparoscopic excision of pulmonary bullae with small incision in the treatment of spontaneous pneumothorax

目的：探讨腹腔镜下小切口肺大疱切除术治疗自发性气胸的临床应用。方法：回顾分析为45例自发性气胸患者行腹腔镜下小切口肺大疱切除术的临床资料。结果：全组均无中转开放手术,切口甲级愈合,复查胸片示肺复张良好,患侧上肢活动不受限,术后无并发症发生。随访3个月~5年无一例复发。结论：采用腹腔镜下小切口肺大疱切除术治疗自发性气胸,术中同时用高浓度碘酒胸膜固定＋改良胸腔闭式引流术,手术简单易行,患者损伤轻,既达到了微创化效果,又可节省治疗费用,且疗效可靠,有效防止了气胸复发。在缺少胸腔镜设备的情况下,值得广大基层医院推广应用。

Objective：To explore the clinical application of laparoscopic excision of pulmonary bullae with small incision in the treatment of spontaneous pneumothorax.Methods：Retrospective analysis was made on clinical data of 45 patients who suffered from spontaneous pneumothorax and underwent laparoscopic resection of pulmonary bullae with small incision.Results：No patients were converted to open surgery,incision healed well,good pulmonary reexpansion was confirmed by re-examination of X-ray chest film.Activation of affected upper limb wasn＇t limited.No postoperative complications occurred.No recurrence of pneumothorax was found in the follow-up from 3 months to 5 years.Conclusions：The surgical method is easy and feasible by using laparoscopic excision of pulmonary bullae with small incision in the treatment of spontaneous pneumothorax and application of high concentration of iodine for pleural fixation and modified closed thoracic drainage in the intra-operation.Patients have mild injury with minimally invasive effect and less cost.It is effective in preventing recurrence of pneumothorax,with less surgical injury and reliable therapeutic effect.In the absence of thoracoscopic equipment,this method is worthy of application and popularization in primary hospital.