电视辅助胸腔镜手术治疗孤立性肺结节临床效果研究

The Clinical Effect on Video-assisted Thoracoscopic Surgery for Solitary Pulmonary Nodule

目的探讨电视辅助胸腔镜手术治疗孤立性肺结节临床效果。方法回顾性分析2012年1月-2013年3月我院手术治疗的60例孤立性肺结节患者的临床资料，其中40例患者行VATS手术（VATS组），20例患者行传统开胸手术（开胸组）。比较两组患者孤立性肺结节病理性质、术中出血量、手术时间、胸管留置时间、胸腔引流量、住院时间、住院总费用及术后并发症率。结果两组患者孤立性肺结节的病理特征比较无统计学差异（x2=6．3442，P=0．5002）。VATS组患者术中出血量、胸腔引流量明显少于开胸组（P〈0．01或P〈0．05），手术时间、胸管留置时间及住院时间明显短于开胸组（P〈0．01），住院总费用与开胸组比较无统计学差异（P〉0．05）。两组术后并发症发生率比较差异无统计学意义（x2=3．5337，P=0．0601）。结论电视辅助胸腔镜手术治疗孤立性肺结节损伤小，患者恢复快，效果确切，值得临床推广应用。

Objective To study the clinical effect of video-assisted thoracoscopic surgery （VATS） in the treatment of solitary pulmonary nodule. Methods A total of 60 cases with solitary pulmonary nodules treated in our hospital from January 2012 to March 2013 were analyzed retrospectively. 40 cases patients regarded as VATS group were underwent VATS, and 20 patients regarded as thoracotomy group were underwent conventional thoracotomy. The pathological nature of solitary pulmonary nodules, intra-operative blood loss, operative time, chest tube duration, chest drainage volume, hospital stay, hospital costs and post-operative complication rate were compared between two groups. Results There was no statistic difference in pathological features of solitary pulmonary nodules between two groups （x2 =6.3442, P =0.5002）. Compare to thoracotomy group, the intra-operative blood loss and chest drainage volume were less （P 〈 0.01 or P 〈 0.05 ）, and the operation time, chest tube duration and hospital stay were shorter in VATS group （P 〈0.01 ）, but the total cost of hospitalization was no statistic difference （P 〉 0.05）. There was no statistic difference in incidence of post-operative complication between two groups （x2 = 3. 5337, P = 0.0601 ）. Conclusion VATS is an effective surgical procedure with mini-invasive and fast recovery for solitary pulmonary nodules, and is worthy of clinical application.