单孔胸腔镜治疗自发性气胸合并肺大疱78例分析

Analysis of 78 cases of spontaneous pneumothorax complicated with pulmonary bullae treated by singlehole thoracoscopy

目的探讨单孔胸腔镜治疗自发性气胸合并肺大疱的疗效。方法回顾性分析78例自发性气胸合并肺大疱患者的临床资料,患者均采用单孔胸腔镜治疗,观察治疗效果。结果 78例患者均在单孔胸腔镜下成功完成手术,无中转开放手术和转为三孔胸腔镜手术病例。手术时间30～90 min,平均手术时间(45.7±14.8)min;术中出血量15～100 ml,平均术中出血量(50.8±17.7)ml;切口长度2～3 cm,平均切口长度(2.5±0.8)cm;术后拔管时间3～7 d,平均术后拔管时间(3.5±2.1)d。术中术后无患者死亡,无严重并发症出现。随访6～27个月,平均随访时间(17.9±9.7)个月。结论单孔胸腔镜手术显著减少了自发性气胸合并肺大疱患者的手术创伤,在加速康复外科中有广泛的应用空间。

Objective To discuss the efficacy of spontaneous pneumothorax complicated with pulmonary bullae treated by single-hole thoracoscopy. Methods The clinical data of 78 patients with spontaneous pneumothorax complicated with pulmonary bullae were retrospectively analyzed. All patients were treated by single-hole thoracoscopy, and the treatment effect was observed. Results All 78 patients were successfully operated under single-hole thoracoscopy. No cases were converted to open surgery or to three-hole thoracoscopic surgery, with operation time as 30~90 min, mean operation time as(45.7±14.8)min, intraoperative bleeding volume as 15~100 ml, mean intraoperative bleeding volume as(50.8±17.7)ml, incision length as 2~3 cm,mean incision length as(2.5±0.8)cm, postoperative extubation time as 3~7 d, mean postoperative extubation time as(3.5±2.1)d. No patient died after operation and no serious complications occurred. The patients were followed up for 6 ~ 27 months, and the average follow-up time was(17.9±9.7) months. Conclusion Singleport thoracoscopic surgery significantly reduces the surgical trauma of patients with spontaneous pneumothorax complicated with bullous bullae, and it has wide application value in accelerated rehabilitation surgery.