电视胸腔镜手术处理血胸的利弊分析

Our experiences of treatment of sponteneous or traumatic hemothorax under videothoracoscopy.

目的 探讨电视胸腔镜手术对血胸处理的适应证。 方法 对 4 5例血胸在电视胸腔镜下进行诊断和治疗。其中 18例为自发性血气胸 ,2 4例为创伤性血气胸 ,手术后血胸 2例。 结果 手术时间 (15～ 130 )分钟 ,平均 5 2分钟。手术中从胸内清除的血量 (40 0～ 340 0 )ml,平均 14 6 0ml。术后留置胸腔闭式引流管 (1～ 4 ) ,天平均 1 5天。全组无手术死亡。无中转剖胸手术 ,亦未发生术后并发症。术后随访中未见胸内积血机化征象。 结论 电视胸腔镜手术适应于自发性血胸、活动性血胸、凝固性或包裹性血胸以及并发化脓感染的血胸。

Objective To evaluate the valne ot treatment of spontanous or traumatic hemothorax with video-assisted thoracic surgery(VATS). Method 45 patients with hemothorax underwant VATS from November 1996 to October 2001.Among them spontaneous hemopneumothorax was in 18 cases, traumatic hemothorax in 25 and hemothorax after thoracotomy in 2. Results Operation time was 15min～130min with an average of 52min.Evacuated blood from chest cavity was 400ml～3400ml with an average of 1460ml.The mean time to removal of chest drainage tubes was 1.5 days (1day～4days).There was no perioperative death and no complication occurred.All patient have been followed up for one month to 3 years.There was no retained hemothorax,empyema and fibrothorax. Conclusions VATS is a safe,minimal invasion,accurate, efficient and is particularly advisable for spontaneous or traumatic hemothorax.