电视胸腔镜下单切口并2%浓碘酊胸膜固定治疗首次发作自发性气胸130例

Video-assisted thoracoscope order incision and 2% iodine tincture pleural fixed treatment with the first attack 130 cases of spontaneous pneumothorax

目的探讨电视胸腔镜下(video-assisted thoracoscopic surgery,VATS)单切口并2%浓碘酊胸膜固定治疗首次发作自发性气胸(primary spontaneous pneumothorax,PSP)的疗效及安全性。方法选取首次发作PSP患者130例,气管双腔插管静脉吸入复合全麻,置镜口位于患侧腋中线第7、8肋间,置Trocar作观察孔,位于腋前线第3或4肋间、腋后线第5或6肋间,切口长1.5～2.0cm,分别进操作器械。在电视屏幕监视下进行胸腔内病变探查及手术。结果 130例全部治愈,无中转开胸或改行多切口术式,无死亡病例。平均手术时间(58.5±19.7)min,术中出血(151.6±89.4)ml,术后于2～7d内拔除引流管。住院时间平均3～11d,平均8d。术后并发皮下气肿2例,并发症率1.5%。无伤口感染,无再次手术或重新留置胸管患者,无其他并发症。结论本手术治疗首次发作PSP出血量少、手术时间短、术后住院时间短、术后胸管留置时间少,呼吸道并发症低,值得临床推广。

Objective To explore the thoracoscope （video-assisted thoracoscopic surgery, VATS） sin- gle incision and 2% iodine tincture pleural fixed treatment with the first attack of spontaneous pneumothorax （primary spontaneous pneumothorax, PSP） safety and efficacy. Methods The first attaek in 130 eases of PSP, tracheal intubation double cavity inhaled compound vein anesthesia, buy mirror of the mouth is located in the midline armpit 7, 8 between rib, buy Troear to observation hole, is located in the front line 3 or4 71：2141 intereostals, armpit line 5 or 6 after intercostals, incision 1.5 ~ 2. 0 em long, respectively, the operation equip- ment. In the TV screen monitoring under chest cavity lesions and the surgical exploration. Results 130 eases were all cured, and no transit thoraeotomy or switehing more surgical incision, no deaths. Average operation time （58.5± 19. 7 min, intraoperative hemorrhage （ 151.6 ± 89.4 ml, postoperative in 2 ~ 7 d pulling in the tube. The length of time the average 3 to 11 days, in average, eight days. Postoperative concurrent subcutane- ous emphysema in 2 cases, complication rate was 1.5%. No wound infection, no again surgery or to a lien chest tube patients, no other eomplications. Conclusion The first attack PSP surgical treatment, operation time less blood loss was short, postoperative hospitalization time is short, the chest tube lien less time, respira- tory complications low, and clinical promotion.