胸腔镜两孔法术式对肺大疱切除的疗效及VAS评分的影响

Effect of Thoracoscopic Two-hole Method on Pulmonary Bulla Resection and the Effect of VAS Score

目的:研究电视辅助胸腔镜手术(video-assisted thoracic surgery,VATS)下两孔法术式对肺大疱切除的疗效及VAS评分的影响。方法:从2014年5月至2016年5月,我院共有98例肺大疱患者接受VATS下手术切除术。以患者自愿将其分成观察组(49例)和对照组(49例)。观察组患者采用两孔法切除术;对照组患者传统传统三孔法切除术;对比两组围术期手术时间、术中出血量、切口长度、拔管时间及住院时间,肺功能,VAS评分及VRS评分,术后并发症、一年复发及一年气胸发生情况。结果:两组患者手术时间及术中出血量差异无统计学意义,手术切口长度、拔管时间及住院时间观察组均少于对照组;治疗前后两组患者肺功能对比,差异均无统计学意义;治疗前两组患者VAS评分及VRS评分均差异无统计学意义,治疗后两组患者VAS评分及VRS评分均下降,且观察组下降幅度均优于对照组(均P<0.05);两组患者治疗后并发症、一年复发及一年气胸发生率差异均无统计学意义(均P>0.05)。结论:VATS下两孔法与三孔法术式对肺大疱切除后,患者症状均得到安全有效的缓解,且两孔法术式具有疼痛少、创伤小、术后恢复良好且快等特点,值得临床借鉴。

Objective： To explore the video-assisted thoracoscopic surgery（ video-assisted thoracic,surgery,VATS） under the influence of the two hole type spell bullae of lung resection and VAS score efficacy.Methods： From May 2014 to May 2016,98 patients with bullous pulmonary bullae were operated under VATS. Under the advice of the physician,the patients were voluntarily divided into the observation group（ 49 cases） and the control group（ 49 cases）. The patients in the observation group were excised by two-hole method,and the traditional traditional three-hole resection was performed in the control group. The perioperative time,intraoperative blood loss,incision length,extubation time and hospitalization time,pulmonary function,VAS score and VRS score,postoperative complications,recurrence of one year and incidence of one year pneumothorax in two groups were compared. Results： There was no statistical difference in operative time and intraoperative blood loss between the two groups. The length of incision,extubation time and hospitalization time in the observation group were significantly less than those in the control group. The difference of lung function between the two groups before and after treatment was not statistically significant. Before treatment,there was no significant difference in the VAS score and VRS score between the two groups. After treatment,the VAS score and VRS score of the two groups decreased significantly,and the decrease in the observation group was significantly better than that in the control group（ P〈0.05）. There was no significant difference in the incidence of complications,one year recurrence and the incidence of one year pneumothorax in the two groups（ P〈0.05）. Conclusion： The two hole method and three type of spell bullae of lung resection in patients with symptoms under VATS are alleviated effectively the safety,and the two hole spell has less pain,less trauma,postoperative recovery and good characteristics such as fast,and it is worthy of reference.