三孔法胸腔镜技术治疗原发性气胸回顾性分析

Treatment of primary spontaneous pneumothorax by VATS surgery：a retrospective study

目的 回顾性分析总结三孔法电视胸腔镜（VATS）技术治疗原发性气胸的临床经验.方法 收集采用三孔法VATS技术行手术治疗的276例原发性气胸患者资料,总结临床经验.结果 手术时间（41.7 ±2.1）min;均为微量出血；中转辅助小切口手术5例；术后胸腔闭式引流拔管时间（6.7±1.2）d；术后轻度漏气27例,中度漏气9例,无重度漏气；术后继发肺不张7例,肺部感染2例,复张性肺水肿1例；术后随访（10.2±1.7）个月,复发7例,再次手术1例.结论 三孔法VATS技术具有手术时间短、创伤小、并发症少、恢复快、住院时间短等优势,且术后复发率低,是治疗原发性气胸的理想术式.

Objective To summary and analysis the clinical experiences on the three hole method of VATS surgery in treatment of primary spontaneous pneumothorax.Methods The clinical data of 276 cases of primary spontaneous pneumothorax undergoing VATS surgery from July 2005 to July 2011 were analyzed retrospectively.Results The operating times were 25 to 76 minutes,averaging （41.7 ± 2.1） minutes ; all with traces of bleeding; transiting assisted small incision operation in 5 cases;postoperative thoracic closed drainage extubation time of 4-13 days,average （6.7 ± 0.2） days,mild postoperative air leakage in 27 cases,moderate in 9 cases without severe leakage,leakage,postoperative pulmonary atelectasis in 7 cases,pulmonary infection in 2 cases,reexpansion pulmonary edema in 1 cases,postoperative follow-up for 6-17 months,averaging（10.2 ± 1.7） months,recurrence occurred in 7 cases,1 case of operation again.Conclusion Three hole method of VATS technique has short operating time,less trauma,fewer complications,faster recovery,shorter hospitalization time and other advantages,and the recurrence rate is low,which is the ideal mode of operation for the treatment of primary spontaneous pneumothorax.