在X线透视配合下电视胸腔镜治疗自发性气胸

Video-assisted thoracoscopic treatment of spontaneous pneumothorax

目的 探讨在X线透视配合下电视胸腔镜在自发性气胸治疗中的作用。方法 对 10 3例自发性气胸病人施行电视胸腔镜手术 ,其中原发性气胸 79例 ,继发性气胸 2 4例 ;手术指证为 :(1)气胸有反复发作史 ,(2 )胸腔闭式引流后仍持续性漏气 (>7d)者 ,(3)合并有血胸、胸腔积液者 ,(4)初次发作CT扫描发现有明确的肺大泡者。结果 无手术死亡病例 ,中转开胸率为 2 .91% ,复发率为 0 .97% ,并发症发生率为 3.81% ,平均术后住院天数为 5 .6d。结论 在治疗自发性气胸中 ,电视胸腔镜手术是一种优于常规开胸手术和内科保守治疗的治疗方法。

Objective To propose a treatment protocol by videothoracoscopy in spontaneous pneumothorax. Methods One hundred and three patients underwent Video assisted thoracoscopic (VATS) treatment of spontaneous peumothorax and hemothorax. Indications included recurrent pneumothorax, persistent air leakage following conservative therapy, complicated hemothorax and CT scan identified bullae formation. Results No operative deaths occurred, conversion rate was 2.91%, recurrence rate was 0.97%, complication rate was 3.81% and mean postoperative hospital stay was 5.6 days. Conclusions VATS treatment of spontaneous pneumothorax is better than open chest surgery and also superior than conservative therapy.