电视胸腔镜下治疗无明显肺大泡的自发性气胸39例体会

Video- assisted thoracoscopic treatment for spontaneous pneumothorax with no obvious bullae

目的探讨无明显肺大泡自发性气胸患者的发病机理及胸腔镜下外科治疗方法。方法2006年至2010年共收治此类患者共39例，所有病例入院时经术前X片检查均确诊为单侧复发性自发性气胸，肺压缩20％-80％不等，18例行肺尖泡性气肿组织楔形切除及胸膜摩擦固定术，15例行肺尖泡性气肿组织楔形切除及肺小泡结扎、胸膜摩擦固定术，6例行单纯胸膜摩擦固定术。结果所有病例均一期痊愈出院，随访3—34个月无复发病例。结论电视胸腔镜下无明显肺大泡的气胸患者部分合并有胸膜下肺气肿和肺小泡，胸膜摩擦固定术是治疗和预防术后复发的有效方法。

Objective To examine video - assisted thoracoscopic treatment for spontaneous pneumothorax with no obvious bullae. Methods Clinical data of 39 patients who were diagnosed as unilateral recurrent spontaneous pneumothorax in the absence of no obvious bullae by X - ray examination and admitted to our department from 2006 to 2010 were retrospectively analyzed. The lung volume was compressed by 20% to 80%. Apex subpleural emphysema tissue wedge resection combined pleural abrasion was per- formed in 18 cases,apical subpleural emphysema line wedge resection and bleb ligation combined pleural abrasion in 15 cases and pleural abrasion alone in 6 cases. Results All patients were cured. No recur- rence was found during follow - up of 3 to 34 months. Conclusion For patients with spontaneous pneumo- thorax in the absence of no obvious bullae found by thoracoscopy, pleural abrasion is an effective method that can prevent the postoperative recurrence.