胸腔镜两孔法与常规三孔法手术切除肺大疱的疗效比较

Comparison of the efficacy of video assisted thoracic surgery using two ports and three ports for pulmonary bullae

目的 比较胸腔镜两孔法与常规三孔法手术切除肺大疱的临床疗效.方法 回顾性分析120例采用胸腔镜治疗的肺大疱患者的临床资料,其中采用常规三孔法手术的患者62例（三孔组）,两孔法手术的患者58例（两孔组）.术后对两组患者进行随访,比较两组手术时间、术中出血、拔管时间、术后胸腔引流液量、住院时间、术后6 h、1 d、3 d、1周的疼痛程度及术后并发症.结果 两组手术时间和术中出血量比较差异均无统计学意义（t=-0.845、-1.164,均P〉0.05）.两孔组拔管时间[（3.2±1.6）d]、术后胸腔引流液量[（270.8±192.4）mL]和住院时间[（5.9±2.1）d]明显少于三孔组（t=-4.972、-2.637、-4.601,均P〈0.05）.两组术后无明显并发症,全部顺利康复出院,随访无复发和其他并发症.术后6 h、1 d、3 d、1周时两孔组患者的VAS评分均明显低于三孔组（t=-5.888、-6.682、-4.190、-5.710,均P〈0.01）.结论 胸腔镜两孔法手术的临床疗效明显,安全性较高,有较高的推广应用价值.

Objective To compare the clinical efficacy of video assisted thoracic surgery using two ports and three ports for pulmonary bullae.Methods Clinical data of 120 patients used video assisted thoracic surgery in the treatment of pulmonary bullae were retrospectively analyzed.62 patients with three ports conventional surgery were selected as three ports group,58 patients with two ports method were selected as two ports group.The two groups were followed up after operation,and the operation time,intraoperative bleeding,extubation time,postoperative drainage volume and hospital stay,the pain scores at postoperative 6h,1 day,3 days,1 week and postoperative complications were compared between the two groups.Results There were no significant differences in operative time and blood loss between the two groups（t=-0.845,-1.164,all P〉0.05）.After operation,the extubation time[（3.2±1.6）d],postoperative thoracic drainage[（270.8±192.4）mL]and hospitalization time[（5.9±2.1）d] of the two ports group were significantly less than those of the three ports group（t=-4.972,-2.637,-4.601,all P〈0.05）.The two groups had no postoperative complications,all patients recovered and discharged,followed up,there was no recurrence and other complications.6h,1 day,3 days and 1 week after surgery,the VAS scores of the two ports group were significantly lower than those of the three ports group（t=-5.888,-6.682,-4.190,-5.710,all P〈0.01）.Conclusion The clinical curative effect of video assisted thoracic surgery using two ports is obvious,the safety is high,and it has high popularization and application value.