胸腔镜治疗多发胸膜下肺大疱自发性气胸

Clinical study of video-assisted thoracoscopic surgery in the treatment of subpleural multiple blebs in patients with primary spontaneous pneumothorax

目的探讨在自发性气胸电视胸腔镜手术治疗过程中以结扎速处理多发胸膜下肺大疱的可行性及疗效。方法 103例在电视胸腔镜手术中探查发现多发胸膜下肺大疱的自发性气胸患者分为两组,其中Ⅰ组采用低能量电凝治疗,Ⅱ组采用结扎速处理。结果与Ⅰ组相比,Ⅱ组术后胸管留置时间显著缩短(P<0.05),两组患者手术时间、使用直线切割缝合器钉仓数目、术中出血、术后持续性肺漏气、术后住院时间以及术后复发,无明显差异(P>0.05)。结论在自发性气胸术中以结扎速处理多发散在胸膜下肺大疱疗效满意,值得推广。

Objective To discuss the feasibility and efficacy of video-assisted thoracoscopic surgery in the treatment of subpleural multiple blebs in patients with primary spontaneous pneumothorax. Methods Multiple subpleural blebs were found in 103 patients with primary spontaneous pneumothorax by VATS, who were divided into two groups in advance. The group I was treated with low energy electrocoagulation, and the group I1 was treated with LVSS. The outcomes were compared. Results Compared with the group I , the duration of drainage was signifi- cantly shorter in the group II （P 〈 0.05）. There was no significant difference in the duration of operation, blood loss, the number of applied staples, persistent air leak, the duration of postoperative hospital stay, and relapse of ip- silateral spontaneous pneumothorax （P 〉 0.05 ）. Conclusion The treatment of multiple blebs with LVSS during VATS for primary spontaneous pneumothorax is reliable and effective, and it＇ s worth to be applied in clinical practice.