全胸腔镜与开胸手术治疗创伤性血气胸的对比分析

Comparative Analysis of Total Thoracoscopy and Thoracotomy in the Treatment of Traumatic Hemothorax

目的探讨全胸腔镜与开胸手术治疗创伤性血气胸的疗效。方法回顾性分析我院2015年1月~2017年5月手术治疗的创伤性血气胸患者115例,按照手术方式分为开胸组60例和VATS组55例。开胸组采用传统开胸手术治疗创伤性血气胸,VATS组采用全胸腔镜手术治疗创伤性血气胸。比较两组患者手术时间、术后当日引流量、术后拔引流管时间、镇痛时间、术后住院时间、住院费用、术后并发症以及随访情况。结果开胸组手术时间、术后当日引流量、术后拔引流管时间、镇痛时间及术后住院时间均高于VATS组,差异具有统计学意义(P<0.05)。两组患者住院费用比较,差异无统计学意义(P>0.05)。两组患者术后并发症率相比,差异无统计学意义(P>0.05)。术后随访1~3个月,均无复发及死亡。结论全胸腔镜手术治疗创伤性血气胸,较传统开胸手术创伤小、手术时间短、疼痛轻、并发症少、恢复快,对患者的影响轻、患者容易接受,适合在临床推广应用。

Objective To investigate the efficacy of total thoracoscopic and thoracotomy in the treatment of traumatic hemothorax.Methods A retrospective analysis of 115 patients with traumatic hemothorax in our hospital from January 2015 to May 2017 was performed.According to the surgical procedure,60 patients were divided into open chest group and 55 patients in VATS group.The thoracotomy group was treated with traditional thoracotomy for traumatic hemothorax,and the VATS group was treated with total thoracoscopic surgery for traumatic hemothorax.The operation time,the day-to-day drainage,the postoperative drainage time,the analgesia time,the postoperative hospital stay,the hospitalization cost,postoperative complications and follow-up were compared between the two groups.Results The operation time of the thoracotomy group,the drainage volume on the day after surgery,the time of postoperative drainage,the time of analgesia and the postoperative hospital stay were higher than those of the VATS group,and the difference was statistically significant（P〈0.05）.There was no significant difference in hospitalization costs between the two groups（ P〉0.05）.There was no significant difference in the postoperative complication rate between the two groups（ P〉0.05）.There was no recurrence and death after 1 to 3 months of follow-up.Conclusion Total thoracoscopic surgery for traumatic hemothorax is less traumatic,shorter operation time,less pain,less complications and quicker recovery than traditional thoracotomy.It has a light impact on patients and is easy for patients to accept.It is suitable for clinical application.