慢性阻塞性肺病合并自发性气胸的治疗方式

Therapeutic methods for COPD with spontaneous pneumothorax

目的探讨和比较胸腔镜手术和传统开胸手术治疗慢性阻塞性肺病(COPD)并发自发性气胸患者的临床治疗效果。方法分析2010年2月—2013年12月在本院胸外科接受治疗的90例COPD患者临床资料,纳入研究患者根据治疗方案随机分为胸腔镜治疗组(观察组)和传统开胸治疗组(对照组)各45例,比较2组患者的基线资料、临床状况、肺功能相关指标、并发症。结果观察组患者的手术时间(t=14.46,P<0.01)、术后疼痛时间(t=9.358,P<0.01)、术中出血量(t=11.11,P<0.01)、引流管时间(t=8.312,P<0.01)及住院时间(t=12.32,P<0.01)均低于对照组,差异有统计学意义。治疗前2组患者的每分钟最大通气量(MVV)、用力肺活量(FVC)、1秒用力呼气容积(FEV1)差异均无统计学意义(P均>0.05);而治疗2周后观察组患者的MVV(t=6.430,P<0.01)、FVC(t=2.173,P=0.032)、FEV1(t=3.033,P=0.003)均显著高于对照组。2组患者的术后并发症差异均无统计学意义(P均>0.05)。结论对COPD合并自发性气胸患者行胸腔镜手术治疗效果明显优于传统开胸手术。

Objective To analyze the efficacy of thoracoscopic surgery and conventional thoracotomy for COPD patients with spontaneous pneumothorax.Methods Clinical data of COPD patients with spontaneous pneumothorax was retrospectively analyzed.Patients were divided into observation group（thoracoscopic surgery）and control group（conventional thoracotomy）.The efficacy of different treatments was compared and analyzed.Results The operative time,postoperative pain time,blood loss,drainage time and hospital stay in observation group was significantly lower than those in control group.There were no significant differences in MVV,FCV,FEV1 between two groups before treatment.The levels of MVV,FCV,FEV1 in observation group 2weeks after treatment were significantly higher than control group.Conclusion Efficacy of thoracoscopic surgery is significantly better than conventional thoracotomy for COPD patients with spontaneous pneumothorax.