胸腔镜下经皮肾镜无孔操作治疗凝固性血胸的疗效

The clinical effects of surgical treatment of coagulated hemothorax with thoracoscope and percutaneous nonporous nephroscope

目的:分析胸腔镜下经皮肾镜术式与传统胸腔闭式引流术联合尿激酶对凝固性血胸的治疗效果。方法:选取凝固性血胸治疗的76例患者,随机分为胸腔镜组(实验组,n=41)与胸腔闭式引流术配合对照组(对照组,n=35),对比两组患者手术时间、术后引流量、置管时间、住院时间及并发症等情况。结果:实验组手术时间、术后引流量及置管时间均明显优于对照组,差异有统计学意义(P<0.05);实验组复查良好例数及满意度明显高于对照组,住院时间、并发症明显少于对照组,差异有统计学意义(P<0.05);实验组疗效评价明显优于对照组,差异有统计学意义(P<0.05)。结论:胸腔镜下经皮肾镜术式较传统胸腔闭式引流术联合尿激酶对凝固性血胸疗效更好,患者康复更快,在保证临床疗效的基础上,实现了微创与美容的结合,值得临床推广应用。

Objective： To analyze the clinical effects of thoracoscopic surgery assisted with percutaneous nephroscopy and traditional thoracic drainage ＋ urokinase injection in the treatment of coagulated hemothorax. Methods： Seventy-six patients with coagulated hemothorax were selected for the study and randomly divided into two groups： the thoracoscopic surgery assisted with percutaneous nephroscope group（ experimental group,n = 41） and the traditional thoracic drainage ＋ urokinase injection group（ control group,n = 35）.The operative time,volume of drainage,catheter time,hospital stay and complications in the two groups were collected and analyzed. Results： The mean operative time,volume of drainage,the catheter time,the average hospital stay and complications in the experimental group were significantly less than those in the control group（ P〈0. 05）,and the quantity of patients in good condition after reexamination,the rate of satisfaction for the treatment and the total effective rate of the experimental group were obviously higher than those of control group（ P〈0. 05）. Conclusions： Thoracoscopic assisted with percutaneous nephroscopy in the treatment of coagulated hemothorax could get better clinical effect and recovery than traditional thoracic drainage plus urokinase injection. This procedure combines mini-invasion and cosmesis on the basis of clinical effectiveness.