电视胸腔镜与常规开胸术对自发性气胸治疗疗效的临床研究

Clinical research of video-assisted thorascopic surgery(VATS) and traditional operation methods to treat the spontaneous pneumothorax

目的探讨电视胸腔镜手术与常规开胸手术对自发性气胸患者的临床治疗效果。方法将2009年6月至2011年12月在我科接受治疗的64例自发性气胸患者随机分为观察组和对照组,观察组33例行电视胸腔镜手术治疗,对照组31例行常规开胸手术治疗,对两组患者的手术切口长度、手术时间、胸管留置时间、术中出血量、术后引流量、术后住院天数、复发率等临床指标进行对比分析。结果观察组比对照组患者的手术切口长度短(t=15.78,P<0.001),手术时间短(t=4.96,P<0.001),术后胸管留置时间少(t=3.89,P<0.001),术中出血量少(t=20.83,P<0.001),术后引流量少(t=3.28,P<0.001),术后住院时间短(t=4.36,P<0.001),差异均有统计学意义。两组患者的复发率比较差异无统计学意义(χ2=2.39,P>0.05)。结论相对于常规开胸手术而言,电视胸腔镜在治疗自发性气胸方面优势明显,值得临床推广。

Objective To investigate the clinical efficacy of video-assisted thoracic surgery（VATS） in the treatment of spontaneous pneumothorax compared with traditional operation methods.Methods 64 cases of spontaneous pneumothorax required surgical therapy in our hospital between June 2009 and December 2011 were randomly divided into observation group and control group.The observation group of 33 patients was treated with VATS,and the control group of 31 patients only received conventional thoracotomy.The length of incision,operative time,chest tube indwelling time,blood loss,postoperative drainage,postoperative hospital stay,recurrence rate of 2 groups and other relevant clinical indicators were analyzed in both groups.Results The patients in observation group had the shorter with the length of incision,operative time,chest tube indwelling time,blood loss,postoperative drainage and postoperative hospital stay for patients compared with the control group（t=15.78,P0.001;t=4.96,P0.001;t=3.89,P0.001;t=20.83,P0.001;t=3.28,P0.001;t=4.36,P0.001）.There was no significant difference in recurrence rate between the 2 groups（χ2=2.39,P0.05）.Conclusion VATS is an effective treatment for spontaneous pneumothorax,and has obvious advantage over traditional operation methods,which is worthy of further promotion.