胸腔镜手术治疗老年肺气肿自发性气胸64例临床分析

EFFECT OF THORACOSCOPIC SURGERY ON SENILE EMPHYSEMA COMBINED WITH SPONTANEOUS PNEUMOTHORAX OF 64 CASES

目的 探讨胸腔镜手术对老年肺气肿自发性气胸患者的临床疗效,并对其安全性进行分析。方法 选取2012年9月~2014年9月收治的128例老年肺气肿自发性气胸患者作为研究对象。按照治疗方式不同,分为对照组（保守治疗）和研究组（胸腔镜手术）,每组各64例。比较两组患者预后及临床疗效。结果治疗后,两组患者住院时间比较,无显著性差异（P〉0.05）。对照组患者的气胸复发率（18.75%）、胸腔感染率（15.63%）均明显高于研究组（3.13%、4.69%）,具有显著性差异（P〈0.05）。两组患者住院费用、疼痛评分比较,差异具有统计学意义（P〈0.05）。术前,两组患者肺功能各项指标比较,P〉0.05,无显著性差异;术后两组患者肺功能各项指标组间比较,P〈0.05,具有显著性差异;手术前后两组组内比较,P〈0.05,具有显著性差异。研究组患者治疗总有效率（98.44%）明显高于对照组（87.50%）,差异具有统计学意义（P〈0.05）。结论 胸腔镜手术（单操作口）治疗老年肺气肿自发性气胸,复发率低,有效减轻了患者的痛苦,值得在临床上推广应用。

Objective To explore clinical efficacy of thoracoscopic surgery on patients with senile emphysema and spontaneous pneumothorax and to analyze its safety. Methods 128 patients with senile emphysema and spontaneous pneumothorax admitted by the Hospital from September, 2012 to September, 2014 were selected as research subjects, who were divided into the control group （conservative treatment） and the experimental group （thoracoscopic surgery） according to different treatment methods with 64 patients in each group. The prognosis and clinical efficacy on two groups of patients were compared. Results There was no significant difference （ P 〉 0. 05 ） in the hospital stay of patients after treatment, in two groups. The recurrence rate of pneumothorax and pleural infection rate of patients in the control group hit 18.75% andlS. 63%, being significantly higher （ P 〈 0.05 ） than those in the ex- perimental group at 3.13% and 4.69% respectively. The differences in hospitalization expenses and pain scores of the two groups were statistically significant （P 〈 0. 05）. The comparisons in lung function indicators of the two groups had no significant difference （ P 〉 0. 05）. The comparisons in preoperative and postoperative lung function indicators of two groups were of significant difference （P 〈 0. 05 ）. Total effective rate in the experimental group （98.44%） was significantly higher than that of the control group （ 87.50% ） , and the difference statistically significant （P 〈 0. 05）. Conclusion Thoracoscopic surgery （ single - incision） delivers low recurrence rate in the treatment for senile pulmonary emphysema and spontaneous pneumothorax, effectively relieving the pain of patients and worthy of popularization and application in clinical practice.