单孔胸腔镜手术治疗肺结核合并气胸的临床应用

Clinical experience of uniportal video-assisted thoracoscopic surgery in the treatment of spontaneous pneumothorax patients complicated with lung tuberculosis

目的 探讨单孔电视胸腔镜下治疗肺结核合并气胸的可行性和安全性.方法 回顾性分析我院2013年6月至2014年12月完成的单孔电视胸腔镜手术治疗肺结核合并气胸患者46例的临床资料,记录手术时间、术中出血量、术后引流液总量、带管时间和术后住院天数等.结果 全组手术顺利,无中转传统VATS或开胸手术.平均手术时间54（35~126）min;术中平均出血21（10~200）ml;术后平均引流时间2.6（1~6）d;术后平均住院4.3（3~10）d.术后随访4~12个月,无复发及其他并发症发生.结论 单孔电视胸腔镜手术治疗肺结核合并气胸近期疗效满意,技术可行,手术安全.

Objective To evaluate the feasibility and safety of uniportal video-assisted thoracoscopic sur-gery （ VATS） in the treatment of spontaneous pneumothorax patients complicated with lung tuberculosis. Methods From June 2013 to December 2014, 46 spontaneous pneumothorax patients complicated with lung tuberculosis under-went uniportal VATS were analyzed retrospectively. The perioperative data including operation time, blood loss, the time of intubation, and the duration of hospital stay were collected and reviewed. Results All patients were treated with uniportal VATS without traditional VATS or open approach. The mean operation time, the mean blood loss, the mean time of intubation, and the duration of hospital stay were 54 （35~126） min, 21（10~200） ml, 2. 6 （1~6） days and 4. 3 （3~10） days, respectively. They were followed up 4~12 months, and there was no recurrence and complication. Conclusion Uniportal VATS is a safe, feasible and satisfactory method in the treatment of spontane-ous pneumothorax patients complicated with lung tuberculosis.