电视胸腔镜在创伤性血气胸中的临床应用

To compare the clinical effect of video-assisted thoracoscopic surgery and conventional lobectomy surgery in treatment of chest trauma

目的比较电视胸腔镜手术(VATS)与传统开胸手术治疗创伤性血气胸的临床疗效,探讨VATS在胸部创伤中的可行性与临床价值。方法回顾性分析200例创伤性血气胸患者,其中105例采用VATS进行探查与治疗,95例采用传统的开胸手术进行治疗。对两组的治愈率、平均手术时间、术中出血量、术后保留胸管时间、术后引流量、止痛药应用时间和住院天数进行配对比较。结果两组患者治愈率分别为94.5%和94.3%,差异无统计学意义(P>0.05);VATS组的平均手术时间、术中出血量、术后保留胸管时间、术后引流量、止痛药应用时间和住院天数分别为(101.4±25.2)min、(185.2±153.4)ml、(2.2±0.8)d、(158.8±75.2)ml、(3.0±0.5)d、(8.0±2.2)d,各项指标均明显优于对照组(P<0.05)。结论传统开胸手术和VATS手术均有较好疗效,但VATS可显著缩短手术时间和住院天数,减少术中出血,治疗胸部外伤是一种安全、有效、微创的方法。

Objective To compare the clinical effect of video - assisted thoracoscopic surgery （VATS） and conventional lobectomy in treatment of chest trauma of hemopneumothorax. Methods 200 patients with chest trauma of hemopneumothorax were divided into two groups ： 105 cases of the VATS group （ Cavity mirrors group） were treated by VATS, and 95 cases of the conventional lobectomy group （ control group） were treated by conventional lobectomy surgery, the clinical effects were compared. Results The healing rate of the two groups were 94.5% and 94.3%, respectively. The difference between two groups was not significant （ P 〉 0. 05 ）. The mean operation time, blood loss, postoperative keep chest tube time, postoperative lead flow, painkillers application time and hostility time were respectively （101.4±25.2） min, （185.2±153.2） ml, （2.2±0.8） d,（158.8±75.2）m1,（3.0 ±0.5）d and （8.0±2.2） d, the indexes were better than those in the control group （ P 〈 0.05 ）. Conclusion Both of VATS and conventional lobectomy surgery have good efficacy, but VATS can decrease the operation time and hostility time, reduce the blood loss, and reduce the dosage of painkillers.