腋下小切口手术治疗外伤性气胸患者的

Subaxillary small incision surgery for patients with traumatic pneumothorax

目的观察腋下小切口手术治疗外伤性气胸患者的效果。方法随机选取2016年3月至2018年11月本院收治58例外伤性气胸患者,采用随机数字表法分为观察组(n=29)与对照组(n=29)。对照组采用传统后外侧小切口手术治疗,观察组采用腋下小切口手术治疗。比较两组手术相关指标、肺功能[最大呼气峰流速(peak expiratory flow,PEF)、1s用力呼气容积(forced expiratory volume in 1second,FEVl)]。结果 观察组胸腔积血及空气吸收时间(10.29±2.13)min,短于对照组的(17.18±3.17)min,术中出血量(232.11±65.26)ml、胸管引流量(351.17±74.28)ml,低于对照组的(424.38±79.81)ml、(551.08±78.64)ml,切口长度(5.36±2.29)cm,小于对照组的(19.87±3.05)cm,差异有统计学意义(t=9.715、10.043、9.952、20.487,P=0.000);观察组术后PEF(6.61±1.93)L/s、FEV(l2.80±0.79)L,高于对照组的(5.56±2.01)L/s、(2.23±0.76)L,差异有统计学意义(t=2.029、2.800,P=0.047、0.007)。结论 腋下小切口手术治疗外伤性气胸患者效果确切,具有出血少、手术创伤轻微以及治疗时间短等优点,利于患者肺功能的恢复。

Objective To observe the effect of subaxillary small incision surgery in the treatment of traumatic pneumothorax. Methods 58 patients with traumatic pneumothorax treated at our hospital from March, 2016 to November, 2018 were randomly divided into an observation group and a control group, 29 cases for each group. The control group was treated with traditional posterolateral small incision surgery, and the observation group with subaxillary small incision surgery. The operation indicators, pulmonary function [peak expiratory flow (PEF) and forced expiratory volume in 1 second (FEVl)] were compared between the two groups. Results The time for absorbing thoracic air and blood, intra-operative bleeding volume, thoracic drainage volume, incision length, PEF, and FEV1 were (10.29±2.13) min,(232.11±65.26) ml,(351.17±74.28) ml,(5.36±2.29) cm,(6.61±1.93) L/s, and (2.80±0.79) L in the observation group, and were (17.18±3.17) min,(424.38±79.81) ml,(551.08±78.64) ml,(19.87±3.05) cm,(5.56±2.01) L/s, and (2.23±0.76) L in the control group, with statistical differences (t=9.715, 10.043, 9.952, 20.487, 2.029, and 2.800;all P < 0.05). Conclusion Subaxillary small incision surgery for patients with traumatic pneumothorax is effective and minimally invasive, and can reduce bleeding volume and treatment time and promote the recovery of pulmonary function.