单操作孔胸腔镜手术治疗首次发作原发自发性气胸的临床研究

Clinical study on single-incision video-assisted thoracoscopic surgery in the treatment of first-episode primary spontaneous pneumothorax

目的探讨电视胸腔镜(VATS)单操作孔手术治疗首次发作原发自发性气胸的可行性。方法 82例首次发作的原发自发性气胸患者,其中VATS手术组(A组)35例,保守治疗组(B组)47例。比较两组患者手术前后相关临床指标进行。结果 82例患者均康复出院,两组中均未出现切口血肿、肺部感染、胸腔感染、血胸、顽固性胸痛等并发症,VATS组患者胸管留置时间、住院时间、复发率、疼痛时间、患者满意度方面均优于对照组,两组比较,差异有统计学意义(P<0.05);两组术后胸痛程度比较,差异无统计学意义(P>0.05)。结论在特定的患者中,电视胸腔镜(VATS)单操作孔手术能明显降低首次发作的自发性气胸复发率,该术式安全、有效、可行,值得推广。

Objective To analyze the feasibility of single-incision video-assisted thoracoscopic surgery （VATS） technique in treating first-episode primary spontaneous pneumothorax （PSP）. Methods A retro- spective clinical analysis was made in 82 patients of first-episode primary spontaneous pneumothorax from March 2010 to March 2014. Of them, 35 cases received single-incision video-assisted thoracoscopic surgery （VATS） （group A）, 47 cases were given conservative treatment （group B）. The clinical indexes of two groups were compared. Results All the 82 patients recovered smoothly and were discharged. No complica- tions occurred in both groups, including incision hematoma, pneumonia, empyema, hemotborax and intracta- ble chest pain. The indwelling time of thoracic drainage tube, the length of hospital stay, the postoperative recurrent rate, the pain duration, and the patient satisfaction in group A were significant better that those of group B. There was no significant difference in pain intensity. Conclusion Single-incision video-assisted thoracic surgery may decrease the postoperative recurrence rate of first-episode PSP. I is a safe, effective and feasible procedure, worthy of clinical promotion.