胸腔镜辅助小切口治疗慢性阻塞性肺疾病并气胸的临床疗效分析

Clinical effect of chronic obstructive pulmonary disease and pneumothorax treatment by thoracoscope assisted small incision

目的探讨研究对慢性阻塞性肺疾病(COPD)并气胸的治疗,采用胸腔镜辅助下小切口治疗的临床效果。方法选取2012年1月~2016年12月来我院就诊的118例COPD并气胸患者,随机将这些患者分为对照组和试验组,试验组62例,采用胸腔镜辅助小切口的手术方式进行治疗;对照组56例,采用传统的开胸手术方式进行治疗,对两组患者术后呼吸困难程度、运动能力、肺功能有关的最大通气量(MVV)、用力肺活量(FVC)、1秒用力呼气容积(FEV1)和与手术治疗有关的在院时间、手术时长、引流管放置时间与手术后出血量等相关因素进行比较。结果两组患者手术后病情均好转,但试验组的呼吸困难程度明显低于对照组,运动能力和MVV、FVC及FEV1均明显高于对照组,差异有统计学意义(P<0.05)。试验组的在院时间、引流管放置时间、手术时长与手术后出血量均明显低于对照组,差异有统计学意义(P<0.05)。结论对慢性阻塞性肺疾病并气胸的治疗采取胸腔镜辅助下小切口治疗的临床疗效显著,缩短患者恢复时间,值得推广。

Objective To evaluate the treatment of chronic obstructive pulmonary disease and pneumothorax treatment,to evaluate clinical effect of treatment by thoracoscope assisted small incision. Methods 118 patients with COPD and pneumothorax in our hospital from January 2012 to December 2016 were selected and randomly divided into the control group（56 cases） and the experimental group（62 cases）.The patients of experimental group were treated with thoracoscope assisted small incision surgery,the patients of control group were treated with traditional open chest surgery.The correlating factors of postoperative respiratory distress,athletic ability,indexes associated with lung function such as maximal voluntary ventilation（MVV）,forced vital capacity（FVC）,forced expiratory volume in one second（FEV1）,indexes associated with surgical therapy such as hospital stays,operative time,drain time and blood loss after operation in two groups were compared. Results The patients of both groups recovered after the operation,but the degree of dyspnea was significantly lower in the expeximental group than that in the control group,and the athletic ability and MVV,FVC and FEVI were significantly higher than those in the control group,the difference was statistically significant（P 〈 0.05）.The hospital stays,drain time,operative time and blood loss after operation in two groups in the experimental group were significantly lower than those in the control group,the difference was statistically significant（P 〈 0.05）. Conclusion The treatment of thoracoscope assisted small incision on chronic obstructive pulmonary disease and pneumothorax is effective,which can shorten the recovery time and is worth promoting.