胸腔镜辅助行腋下小切口治疗老年自发性气胸的效果分析

Effect analysis of thoracoscope assisted transaxilary minithoracotomy treating senile spontaneous pneumothorax

目的比较传统外侧切口与胸腔镜辅助行腋下小切口治疗老年自发性气胸的效果,为临床提供参考。方法2013年2月~2015年4月,将68例老年自发性气胸患者随机分成两组,对照组采用传统外侧切口治疗,实验组采用胸腔镜辅助行腋下小切口治疗,比较两组组患者的手术时间、术中出血量、术后疼痛耐受率及胸腔引流管放置时间等。结果实验组的手术时间短于对照组,术中出血量少于对照组,差异有统计学意义（P〈0.05）;实验组的术后疼痛耐受率高于对照组,差异有统计学意义（P〈0.05）;实验组的胸腔引流管放置时间短于对照组,胸腔引流量少于对照组,住院时间短于对照组,差异有统计学意义（P〈0.05）;实验组的住院费用与对照组差异无统计学意义（P〉0.05）。结论胸腔镜辅助行腋下小切口治疗老年自发性气胸,效果良好,手术操作方便,可缩短手术时间,减少出血量,减轻患者的疼痛,加速其术后恢复,同时并未增加住院费用,减小患者的经济压力,值得各位同道参考应用。

Objective To compare the effect of conventional lateral incision and thoracoscope assisted transaxilary minithoracotomy treating senile spontaneous pneumothorax,and to provide reference for clinic. Methods From February2013 to April 2015,68 elderly patients with spontaneous pneumothoraxs were randomly divided into two groups.Control group was treated with conventional lateral incision,while experimental group was treated with thoracoscope assisted transaxilary minithoracotomy.The operation time,bleeding volume during operation,pain tolerance rate after operation and thoracic drainage tube placement time and so on between two groups was compared respectively. Results The operation time in experimental group was less than that of control group,bleeding volume in experimental group was less than that of control group,and the difference was statistical significance（P〈0.05）.Pain tolerance rate after operation in experimental group was higher than that of control group,and the difference was statistical significance（P〈0.05）.Thoracic drainage tube placement time in experimental group was shorter than that of control group,amount of thoracic cavity drainage in experimental group was less than that of control group,and hospital stay in experimental group was shorter than that of control group,and the difference was statistical significance（P〈0.05）.The hospital expenses in experimental group had no statistical significance with than that of control group（P〈0.05）. Conclusion Thoracoscope assisted transaxilary minithoracotomy treating senile spontaneous pneumothorax has good effect with easy operation,and it can shorten operation time,reduce bleeding volume and alleviate pain of patients,and accelerate the postoperative recovery of patients but do not add too much hospital expenses to patients.It reduces the economic pressure and is worthy of reference and application for other doctors.