电视胸腔镜(VATS)在急性胸部创伤中的临床应用研究

Clinical research of video-assisted thoracic surgery in thoracic trauma

目的 探讨电视胸腔镜手术 (VATS)在急性胸部创伤诊治中的应用价值 ,以确定其在急性胸部创伤诊治中的地位。方法 2 0 0 1年 3月 - 2 0 0 3年 6月 ,利用电视胸腔镜技术完成了 6 0例急性胸部创伤手术。其中包括急性胸部开放性损伤胸部探查术 4 9例 ,急性胸部闭合性损伤 11例 (凝固性血胸清除术 6例、浮动胸壁钢板悬吊外固定术 5例。结果 急性胸部开放性损伤急诊探查 ,应用电视胸腔镜成功止血、肺裂伤修补。凝固性血胸应用胸腔镜清除血凝块 ,避免了常规开胸手术 ;浮动胸壁应用胸腔镜行丝线悬吊钢板外固定术达到了恢复快、减少并发症、减轻畸形的效果。结论 合理应用电视胸腔镜治疗部分急性胸部创伤具有创伤小、恢复快、并发症少、利于美容等优点 ,大部分传统急性胸部创伤开胸手术可由胸腔镜手术完成 ,是一种安全、有效的方法。

Objective To evaluate the value of video-assisted thoracic(VATS) surgery in treatment of acute thoracic trauma ,and its position.Methods From March 2001 to June 2003, video-assisted thoracic surgery (VATS) was performed in 60 patients with acute thoracic trauma , including 48 cases of thoracic ascertaining operation of acute opening thoracic trauma,11 cases of acute closing thoracic trauma.(6 cases of removing operation of clotted hemothrax,5 cases of fixing operation outside in flail chest by suspending stencil plate).Results In ascertaining the acute opening thoracic trauma in exergecy,VAT was applied to arrest blood successfully,mend lung split.Also blood block in clotted hemothorax were removed by VAT without thoracotomy.VAT was applied to suspend stencil plate to fix outside with thread.Attaining the effect of recovering quickly reducing complication and relearing deformity.Conclusion Applying VAT reasonably to remedy parts of acute thoracic trauma has the advantages of minimally invasive, speedy recovery, minimally complication and available cosmetology. In acute thoracic trauma most of traditional thoracotomy can be done by VATS. It is a safe and effective method in the treatment of thoracic trauma. [