单操作孔电视胸腔镜在自发性气胸治疗中的应用效果

Application effect of single-operating-hole video-assisted thoracoscopic surgery in treatment of spontaneous pneumothorax

目的探讨单操作孔电视胸腔镜手术(VATS)治疗自发性气胸的效果。方法回顾性分析2014年2月至2016年2月马鞍山市人民医院89例施行VATS治疗的自发性气胸患者临床资料。其中,采取"单操作孔法"49例,采取"三孔法"40例,对比分析两组患者的手术时间、术中出血量、术后胸管引流时间、住院时间以及术后疼痛程度等指标。结果所有患者手术顺利,无一例围手术期死亡,无严重并发症。两组患者在手术时间、术后胸管引流时间以及住院时间等方面比较,差异均无统计学意义(P>0.05);但在术中出血量[(24.4±5.9)m L vs(40.62±8.7)m L]和术后疼痛评分[(3.4±1.1)分vs(6.7±0.9)分]上,单操作孔组均低于三孔组,差异有统计学意义(P<0.05)。结论单操作孔VATS治疗自发性气胸是一种操作简单、效果确切的手术方式,较"三孔法"可进一步减少创伤。

Objective To investigate the effect of single-operating-hole video-assisted thoracoscopic surgery( VATS) in the treatment of spontaneous pneumothorax. Methods The clinical data of 89 patients with spontaneous pneumothorax ever treated by VATS in our hospital from Feb 2014 to Feb 2016 were analyzed retrospectively,with implementation method of the single-operating-hole VATS in 49 cases and the three-hole VATS in 40 cases. The operation time,blood loss,hospitalization time,postoperative drainage time and pain severity between the two groups were compared and analyzed. Results All patients underwent successful operation without severe complications,and none of them died during the perioperative period. In comparison of the operative time,hospitalization time,and postoperative drainage time of chest tube between the two groups,their differences were not statistically significant( P > 0. 05). But the patients with single-operatinghole VATS had lower intraoperative blood loss and postoperative pain scores than those with three-hole VATS,and between them there were statistically significant differences( P < 0. 05). Conclusion The single-operating-hole VATS is a surgical method with simple operation and excellent effect in the treatment of spontaneous pneumothorax,with further fewer operative trauma than the three-hole method.