肺大疱切除术后复发气胸的处理

Postoperative recurrence of pneumothorax after Resection of Pulmonary bleb

目的探讨肺大疱切除术后复发气胸临床特点、处理原则,手术指征、方法及疗效。方法回顾性分析2001年12月至2011年11月肺大疱切除术后复发气胸患者51例,28例保守治疗:穿刺抽气或胸腔闭式引流;23例行胸腔闭式引流术治疗无效,改行手术治疗:其中传统开胸手术治疗6例,胸腔镜辅助小切口(5～8cm)8例,单纯胸腔镜手术9例,并都同期行胸膜固定术。结果手术均顺利,全部治愈。结论肺大疱切除术后复发气胸应积极予以治疗,外科手术治疗并选择合适的胸膜固定术可靠有效;胸腔镜手术较传统开胸手术术恢复快、损伤小,疗效相当。

Objective To investigate the clinic features,operative indication,methods and curative effect of Recurrence of pneumothorax after Resection of Pulmonary bleb Methods retrospective analysis in July 2001-June 2011 pulmonary bleb resection in patients with recurrent pneumothorax 51 cases,28 cases of conservative treatment：puncture pumping gas or chest closed drainage;23 routine chest closed drainage treatment is invalid,surgical treatment profession：the traditional with open thoracic operation in 6,auxiliary vats small incision（5 ~ 8 cm） in 8 cases,simple operation vats in 9 cases,and the same period all do pleural fixation.Results All case are performed well and cured.Conclusion Pulmonary bleb recurrence after resection pneumothorax should give actively therapy,surgical treatment and choose the right pleural reliable and effective fixation;Vats than the traditional thoracotomy surgery was quick recovery,a little injury,curative effect is quite.