单操作孔法与传统双操作孔法治疗自发性气胸的对比性研究

A Comparative Study of Uniportal Video-Assisted Thoracic Surgery Technique versus Traditional Two-Port Video-Assisted Thoracic Surgery Technique for Treatment of Spontaneous Pneumothorax

目的探讨电视胸腔镜(VATS)单操作孔方法行肺大疱切除术治疗气胸的可行性。方法胸腔镜肺大疱切除+胸膜摩擦固定术患者327例,分成单操作孔治疗组194例和传统双操作孔法对照组133例,对比两组手术时间、术后胸腔引流量、术后漏气时间、术后拔管时间、术后复发情况、术中钉仓使用量。结果两组手术时间、出血量、术后复发率及术后住院时间、术中使用钉仓数量比较,差异均无统计学意义(P>0.05);与双操作孔组比较,单操作孔组术后伤口疼痛、麻木均有显著改善(P<0.05)。结论单操作孔治疗法与传统双操作孔法VATS肺大疱切除术治疗自发性气胸疗效相当,但单操作孔术后患者疼痛更轻、麻木感出现较少。

Objective To discuss the feasibility of uniportal video-assisted thoracic surgery （ VATS） technique applied to pulmonary bullae resection for the treatment of spontaneous pneumothorax .Methods Three hundred and twenty-seven cases undergoing video-assisted pulmonary bullae resction and pleurodesis were divided into uniportal VATS technique group （ n=194） and traditional two-port VATS technique group （ n=133） .The clinical data including the operation time , postoperative thoracic cavity drainage volume , postoperative leakage time , postoperative extubation time,postoperative recurrence rate and perioperative staple-using number were compared between two groups .Results There were no significant differences in operation time ,bleeding ,postoperative recurrence ,postoperative hospital stay and perioperative staple-using number between two groups （P〉0.05）.The postoperative pain and wound numbness in the uniportal VATS technique group improved significantly compared with two -port VATS technique group （ P 〈0.05 ） . Conclusion The uniportal VATS technique has similar effect with two-port VATS technique on spontaneous pneumothorax patients undergoing pulmonary bullae resction ,but the patients using the uniportal technique have less pains and wound numbness after operation .