2mm针型胸腔镜的临床应用.docVIP

2 mm针型胸腔镜的临床应用 中华外科杂志 1998年第6期第36卷 临床论著 作者：何建行　杨运有　殷伟强　韦兵　陈满荫　曾仑 单位：510120 广州医学院第一附属医院胸心外科 关键词：胸腔镜检查；胸部疾病 　　【摘要】　目的　掌握新型的2 mm胸腔镜(针镜)的应用。　方法　作者在普通胸腔镜熟练使用的基础上，于1996年7月～1997年7月应用2 mm微型胸腔镜治疗47例患者。胸腔探查和抽液15例，单侧肺大疱切除术11例，双侧肺大疱切除术5例，气胸肺修补术4例，肺楔形切除术3例，肺癌术前分期术2例和术后胸腔探查2例，肺叶切除术2例，食管癌根治术1例，纵隔神经纤维瘤切除术2例。　结果　均达到满意的诊断和治疗效果，无并发症发生。　结论　2 mm针镜创伤小，应用方便，且可在床边操作，对术后了解胸内情况和抽吸胸液有极大的诊断价值和部分治疗价值。但2 mm微镜的视野较小，而且要近镜才能看清病变，器械柔软也影响了操作，需大量实践后才能熟练选择穿刺定位和操作，2 mm微镜应用还需作进一步探讨。 　　Clinical application of 2 mm microthoracoscopic surgery He Jianxing,Yang Yunyou,Yin Weiqiang, et al. Department of Thoracic Surgery, The First Affiliated Hospital of Guangzhou Medical College,Guangzhou 510120. 　　【Abstract】　Objective　To determine the clinical safety and efficacy of microthoracoscopic surgery.　Method　From July 1996 to July 1997,video-assisted thoracoscopic surgery was performed in 47 patients by using 2 mm microthoracoscope.There were 36 males and 11 females.Their age ranged from 40 to 75 years with a mean age of 56.7 years.Surgical procedures included bullectomy (16 patients),wedge resection (3),lung cancer staging (4),lobectomy (2),exploration (15), and resection of mediastinal tumor (2),esophagectomy (1) and repair of pneumothorax (4).Local anesthesia was employed in 18 patients and general anesthesia with double lumen endotracheal tube in 29.　Result　There were no operative mortality and postoperative complications.　Conclusion　2 mm microthoracoscopic surgery could be used in the management of a variety of thoracic conditions.It may be of significant value for diagnostic and therapeutic purposes,but the further study for this new technique is required to determine its safety and effecacy. 　　【Key words】　Thoracoscopy　　Thoracic diseases 　　从1996年7月至1997年7月,我们应用2 mm的针型胸腔镜(微镜)进行47例的内镜手术，使胸腔镜手术创伤更少，应用范围进一步加大，现报告如下。 临床资料 　　1．一般资料: 男36例，女11例；年龄21～75岁，平均56.7岁。疾病种类包括胸腔积液15例，肺大疱16例，自发性气胸4例，肺结核瘤2例，肺错构瘤1例，胸癌术前分期2例，术后胸腔探查2例，肺癌肺叶切除2例，食管癌1例，纵隔神经纤维瘤2例，共行手术47例。 　　2．术式:胸腔探查和抽液15例，单侧肺大疱切除术11例，双侧肺大疱切除术5例，气胸肺修补术4例，肺楔形切除术3例，肺癌术前分期