改良胸腔镜在治疗自发性气胸的应用效果

Clinical analysis of patients with spontaneous pneumothorax by improved two-port thoracoscopy

目的探讨改良双孔胸腔镜在治疗自发性气胸的应用效果。方法分析96例接受胸腔镜手术的自发性气胸患者,其中23例接受了改良双孔胸腔镜手术(改良组),73例接受了标准双孔或三孔胸腔镜手术(标准组);主要分析指标包括手术时间、术中出血量、术后住院时间、术后置管时间和术后疼痛评分。结果改良组和标准组的患者在手术时间[(50.0±4.1)vs(51.4±4.0),P=0.327]、术中出血量[(43.2±6.7)vs(46.4±6.9),P=0.058]、术后住院时间[(6.0±1.4)vs(6.6±1.4),P=0.122]、术后置管时间[(4.5±1.1)vs(4.8±1.1),P=0.377]等方面差异无统计学意义,但改良组的术后疼痛评分显著低于标准组(P=0.002)。结论相比标准胸腔镜,改良胸腔镜治疗自发性气胸切口更加美观、术后疼痛更小。

Objective To investigate effects of the limited two-port video assisted thoracic surgery on treatment of spontaneous pneumothorax .Methods A retrospective analysis of 96 patients with spontaneous pneumothorax who underwent video assisted thoracic surgery was conducted in the present study , in which 23 cases underwent the limited two-port video assisted thoracic surgery while 73 cases treated with the standard three-port video assisted thoracic surgery or the standard two-port video assisted thoracic surgery .The mean operation time , mean intraoperative blood loss and average postoperative hospital stay , average postoperative chest tube duration and postoperative pain rating were analyzed .Results Though no statistically significant difference existed in the mean operation time [（50.0 ±4.1）vs（51.4 ±4.0）, P=0.327], mean intraoperative blood loss [（43.2 ±6.7）vs（46.4 ±6.9）, P=0.058]average postoperative hospital stay[（6.0 ±1.4）vs（6.6 ±1.4）, P=0.122], average postoperative chest tube duration [（4.5 ±1.1）vs（4.8 ±1.1）,P=0.377] between the two group, however, the postoperative pain scores in the limited two-port video assisted thoracic sur-gery group were significantly lower than those in the traditional video assisted thoracic surgery group （P=0.002）.Conclusion There is better cosmetic effect , and lower grade postoperative pain in the limited two-port video assisted thoracic surgery .