胸腔镜在胸部创伤中应用的研究进展

Progress in the application of thoracoscopic surgery in thoracic trauma

创伤患者经常出现严重的胸部损伤,如血胸、肋骨骨折、肺损伤,食管、气管及胸导管损伤虽然少见但常常是患者死亡的主要原因,如果上述胸部创伤没有及时的诊断和治疗,会导致高病死率及远期不良预后。视频辅助胸腔镜(VATS)是外科手术中成熟的技术,在胸部损伤中,VATS可以提供胸腔内结构最大可视化,不但可作为胸部损伤的诊断方法而且能同时进行治疗,本文对VATS在胸部各类创伤中的应用及其优缺点进行综述,并讨论在胸部创伤中使用VATS的禁忌证及注意事项。

Traumatic patients often have severe chest injury.Hemothorax,rib fracture and lung injury are the most common injuries in the chest.Although esophageal,tracheal and thoracic duct injuries are rare,they are often the main causes of death.If the above chest trauma is not timely diagnosed and treated,it can lead to high mortality and long-term poor prognosis.Video-assisted thoracoscopic surgery(VATS)is a mature technique in surgery.In chest injury,VATS can provide maximum visualization of intrathoracic structures,which can be used as a diagnostic method for chest injury and can be treated at the same time.The application of VATS and its advantages and disadvantages are reviewed,and contraindications and precautions for its use in chest trauma are discussed.