电视胸腔镜术在重度阻塞性通气功能障碍患者治疗中的临床研究

The value of VATS in treatment of the patients with severe obstructive pulmonary dysfunction

目的 探讨电视胸腔镜术在重度阻塞性通气功能障碍患者中的治疗的可行性。方法 总结电视胸腔镜手术治疗重度阻塞性通气功能障碍患者的经验和体会。术前肺功能测定 :重度阻塞性通气功能障碍 17例 ,(FEV1<40 % ,FEV1/FVC <40 % )。结果 肺楔形切除 9例 ,肺段切除 1例 ,肺大疱切除 4例 ,心包开窗术 1例 ,后纵隔肿瘤摘除术 1例 ,肺减容术 1例。术中出血为 10～ 10 0ml13例 ;出血 110～ 2 0 0ml4例。术后需呼吸机辅助呼吸 2例 (4 8～68h)。术后出现心律失常 ,胸腔积液 ,漏气等并发症 3例 ,无手术死亡 ,无需手术中输出。结论 VATS手术是一种创伤小、安全性高的手术。电视胸腔镜手术对重度阻塞性通气功能障碍重度肺功能减退患者是首选的方法。

Objectives: To evaluate the feasibility of VATS in treatment of the patients with severe obstructive pulmonary dysfunction.Methods 17 patients with severer obstructive pulmonary dysfunction underwent operations by VATS.Results: Pulmonary wedge resections in 9,pulmonary segmentectomies in 1.bulous ablation in 4,pericardial window in 1,excision of tumor in the posterior mediastinum in 1,pulmonary capacity reduction in 1.Bleeding in the procedure 10～200ml without blood transfusion.2 cases were postoperatively supported by mechanical ventilation(48～68hs).3 patients complicated with arrhythmias,pleura effusion,air leak.There was no mortality.All patients were discharge from hospital.Conclusions:VAST is recommended to be the first choice on the patient with severe obstructive pulmonary dysfunction.