单操作孔手术与开胸手术方式在肺大泡切除中的对比研究

Comparative Study of Single Operation Hole Surgery and Thoracotomy in Pulmonary Bullous Resection

目的探讨单操作孔手术与开胸手术方式在肺大泡切除中的对比。方法收集2016年10月—2018年12月80例胸科手术病例(开胸手术,单操作孔胸腔镜手术),分为试验组40例,采用单操作孔胸腔镜手术进行治疗,对照组40例用开胸手术方式进行治疗。对两组患者手术切口大小、手术时间长短、术后疼痛评分、术后首次下床时间、平均住院时间以及并发症发生率等进行对比分析。结果试验组手术切口大小、手术时间长短、术后首次下床时间、手术之后的疼痛评分、平均住院时间(4.02±1.12)cm、(63.01±2.21)min、(12.02±0.12)h、(4.01±0.13)分、(6.21±1.26)d和对照组(21.14±2.24)cm、(77.15±3.57)min、(22.14±0.24)h、(6.24±1.57)分、(8.62±2.19)d比较有优势(t=5.221、6.346、5.245、6.350、5.721,P<0.05)。试验组并发症低于对照组(χ^2=6.352,P<0.05),试验组并发症中,1例出现切口感染,1例出现出血,总发生2例,发生率是5%。对照组并发症中,5例出现切口感染,4例出现出血,1例出现肺部感染,总发生10例,发生率是25%。结论肺大泡患者实施单操作孔并发症发生率确切,开胸手术切口长,失血多,疼痛评分高,术后疤痕大,术后首次下床时间及住院时间长,疼痛时间较长,恢复缓慢。单操作孔胸腔镜手术切口小,失血少,疼痛评分低,术后瘢痕小,恢复快,并发症发生率明显,患者心理接受程度高,符合近年是倡的微创观念。

Objective To compare the single-hole operation and thoracotomy in the treatment of pulmonary bullous resection.Methods 80 cases of thoracic surgery (open thoracotomy,single-operated thoracoscopic surgery) were collected from October 2016 to December 2018.They were divided into 40 groups of experimental groups and treated with single-operated thoracoscopic surgery.40 patients were treated with open thoracotomy.The size of the incision,the length of the operation,the postoperative pain score,the first time to get out of the hospital,the average length of hospital stay,and the incidence of complications were compared between the two groups.Results The size of the incision,the length of the operation,the first time to get out of the operation,the postoperative pain score,and the average hospital stay were (4.02±1.12)cm,(63.01±2.21)min,(12.02±0.12)h,(4.01±0.13)points,(6.21±1.26)days,and the control group of (21.14±2.24)cm,(77.15±3.57)min,(22.14±0.24)h,(6.24±1.57)points,(8.62±2.19)days were superior(t=5.221,6.346,5.245,6.350,5.721,P<0.05).The complication of the experimental group was lower than that of the control group(χ^2=6.352,P<0.05),in the trial group complications,1 case of wound infection,1 case of bleeding,total incidence of 2 cases,the incidence rate was 5%.In the control group,5 cases had wound infection,4 cases had bleeding,and 1 case had pulmonary infection.There were 10 cases in total,and the incidence rate was 25%.Conclusion The incidence of complication of single operation hole in patients with pulmonary bullae is accurate.The incision is long,the blood loss is high,the pain score is high,the postoperative scar is large,the time of first bedtime and hospitalization is long after operation,and the pain time is longer,recovery is slow.Single-operated thoracoscopic surgery has small incision,less blood loss,low pain score,small postoperative scar,quick recovery,obvious complication rate,and high psychological acceptance.It is in line with the minimally invasive concept advocated in recent years.