微小单孔VATS治疗原发自发性气胸患者的效果及优势分析

Analysis of effect and advantages of micro single hole VATS in treatment of primary spontaneous pneumothorax

目的探讨原发自发性气胸患者采用微小单孔电视辅助胸腔镜治疗的效果及临床优势。方法选取2014年1月-2015年6月在本院选择手术治疗的94例原发自发性气胸进行回顾性分析,其中44例患者采用微小单孔VATS手术治疗(单孔组)、50例患者采用传统VATS手术方法治疗(传统组),对比两组患者的手术指标、术后血清相关指标。结果单孔组引流管留置时间、手术出血量、手术后引流量及患者的住院时间均低于传统组(P<0.05);两组患者的手术时间、肛门排气时间差异不具有统计学意义(P>0.05);单孔组患者的术后疼痛程度显著的低于传统组,差异具有统计学意义(P<0.05);术前,单孔组和传统组的血清α1-AT、IL-1、TNF-α水平差异无统计学意义(P>0.05);术后24h,单孔组血清TNF-α、IL-1、α1-AT水平低于传统组,差异具有统计学意义(P<0.05)。结论微小单孔VATS手术治疗原发自发性气胸手术效果可靠,同时具有术后恢复快、创伤程度小的优势。

Objective To investigate the effect of micro single hole video assisted thoracic surgery （VATS） in treatment of primary spontaneous pneumothorax. Methods From January 2014 to June 2015 in our hospital, 94 cases of surgical treatment of primary spontaneous pneumothorax were retrospectively analyzed, including 44 patients with small single hole VATS surgery （ the single hole group） and 50 patients treated with traditional VATS treatment （the traditional group）. Serum related index indexes of operation and post-operation were compared between the two groups. Results Their drainage time, blood loss, postoperative drainage and hospital stay were lower in the single hole group than in the traditional group （P 〈 0.05）. Operation time and anal exhaust time had no statistical significance between the two groups （P 〉 0.05）. The degree of pain of the single hole group was lower than that in the traditional group （ P 〈 0.05 ）. Before operation, their serum IL-1, TNF-alpha, alpha and 1-AT were not statistically significant （P 〉0. 05）. 34h after operation, the levels of serum IL-1, TNF-alpha and alpha I-AT were lower in the single group than in the traditional group （P 〈 0. 05）. Conclusion Micro single hole VATS operation is reliable, and has the advantages of quick recovery and little trauma in treatment of primary spontaneous pneumothorax.