单孔与单操作孔胸腔镜治疗自发性气胸的对比研究

Comparison of uniportal VATS and single utility port VATS in treatment of spontaneous pneumothorax

目的比较单孔胸腔镜手术(uniportal VATS)与单操作孔胸腔镜手术(single utility port VATS)治疗自发性气胸的疗效。方法回顾性收集2013年1月-2015年12月收治自发性气胸行uniportal VATS治疗的53例患者作为实验组,对照同期53例行single utility port VATS治疗的患者作为对照组,比较两组的手术时间、术中出血量、胸管放置时间、术后住院时间、术后疼痛、术后并发症及远期复发等临床指标。结果 106例患者均顺利完成手术,无死亡及严重并发症发生。实验组和对照组比较,术后24 h疼痛视觉模拟评分(VAS)为(2.60±0.71)vs(3.38±0.84),术后72 h VAS为(1.30±0.51)vs(1.58±0.62),实验组较对照组术后24和72 h疼痛减轻(P<0.05)。两组患者手术时间、术中出血、胸管引流时间、术后住院时间、手术费用和术后并发症的差异均无统计学意义(P>0.05)。随访时间5~36个月,平均19个月,术后无气胸复发。结论单孔胸腔镜治疗自发性气胸与单操作孔两种方法同样安全有效,但单孔法术后疼痛程度更轻,近期疗效满意,值得进一步临床推广。

Objective To compare the efficacy of uniportal VATS and single utility port VATS in treatmentof spontaneous pneumothorax.Method From January2013to December2015,we retrospectively collectedclinical data of53patients with spontaneous pneumothorax who were treated with uniportal VATS,as study group;compared with control group:53patients received single utility port VATS in the same period.The clinical datawas compared between the two groups,including the operation time,intraoperative blood loss,drainage time,postoperative extubation time,postoperative pain score,postoperative hospitalization and recurrence.Results Allpatients were successfully completed the operation,no death and serious complications occurred.There were nosignificant differences in intraoperative blood lose,duration of chest drainage,duration of hospital stay and incidenceof serious postoperative complications between two groups(P>0.05).Mean Visual Analogic Scale(VAS)scorefor24h post-operative pain was:(2.60±0.71)for uniportal VATS and(3.38±0.84)for single utility port VATS(P>0.05),72h post-operative pain was:(1.30±0.51)for uniportal VATS and(1.58±0.62)for single utility portVATS(P>0.05).Follow up5~36months,median follow up was19months.No recurrence occurred during followup.Conclusions The study suggested that both surgical approaches to spontaneous pneumothorax are safe andeffective.Significant differences were found for early post-operative pain between the two approaches,the uniportalway is better.It is worthy of clinical promoting.