电视胸腔镜与开胸手术治疗自发性气胸临床疗效分析

Clinical analysis of video-assisted thoracic surgery and thoracotomy for spontaneous pneumothorax

目的探讨开胸手术(thoraeotomy,TH)和电视胸腔镜手术(video-assisted thoracic surgery,VATS)治疗自发性气胸(spontaneous pneumothorax,SP)的应用范围及疗效。方法回顾性分析261例自发性气胸手术治疗患者的临床资料,其中开胸手术(TH组)75例,电视胸腔镜手术(VATS组)186例。对两组病人的临床指标进行比较。结果 TH组与VATS组手术时间、术后并发症比较差异无统计学意义(P>0.05),术后拔管时间、术后住院天数、手术费用、术后疼痛、术后复发比较差异有统计学意义(P<0.05)。对于老年患者,VATS治疗能取得与年轻患者同样的疗效。结论 VATS治疗自发性气胸创伤小、恢复快,能达到TH治疗效果,VATS可作为自发性气胸的首选治疗方法。

Objective To analyze the advantages,disadvantages,applications and efficacy of video-assisted thoracic surgery（VATS） and thoraeotomy（TH） in the treatment of spontaneous pneumothorax（SP）.Methods To observe the therapeutic effects of 75 cases of spontaneous pneumothorax treated by TH and 186 cases by VATS.Results The operative time and postoperative complications have no statistically significant（P0.05） between the TH and VATS.The postoperative extubation time,postoperative stay,cost of surgery,postoperative pain and postoperative recurrence have statistically significant（P0.05） between the TH and VATS.For elderly patients,VATS treatment can achieve the same effect with younger patients.Conclusion VATS can as effective as TH in the treatment of spontaneous pneumothorax,whereas it can be less invasive and achieve a faster recovery time.For spontaneous pneumothorax patients,VATS should be the preferred treatment.