改良单孔胸腔镜手术治疗自发性气胸临床探究.docVIP

改良单孔胸腔镜手术治疗自发性气胸临床探究 　　摘要：目的 探讨改良单孔胸腔镜手术治疗自发性气胸的可行性及疗效。方法 在传统胸腔镜手术基础上，应用改良的单孔胸腔镜手术（即单操作孔加微管引流）治疗42例自发性气胸患者，并分析术后各项临床指标及疗效。结果 42例患者均在改良单孔胸腔镜下行肺大疱切除术，手术时间40min～70min，平均55min±15min，胸腔闭式引流量150ml～430ml，平均290ml±140ml，术中失血量为10～20ml（15±5）ml，术后胸腔闭式引流管留置时间2d～4d（3±1）d，术后住院时间5～7 d（6±1）d，术后1例患者并发全身广泛皮下气肿，1例患者并发胸腔积液，所有患者随访3月～6月，未出现气胸复发。结论 与传统胸腔镜手术相比，改良的单孔胸腔镜手术治疗自发性气胸，具有创伤更小，切口数目更少及并发症少等优点，该改良术式安全可行，疗效可靠 关键词：单孔电视胸腔镜手术；自发性气胸；改良术式 Abstract：Objective To explore the feasibility and therapeutic effect of modified single port thoracoscopic surgery for spontaneous pneumothorax. Methods In the traditional thoracoscopic surgery on the basis of single hole thoracoscopic surgery with modified（i.e.single hole and microtubule drainage）treatment of 42 cases of patients with spontaneous pneumothorax， and analyze the postoperative clinical indexes and curative effect.Results All of the 42 patients in the modified single port thoracoscopic resection of lung bullae，operation time 40min～70min，average 55min±15min，closed thoracic drainage 150ml～430ml，average 290ml±140ml，intraoperative blood loss was 10～20m（15±5） ml，postoperative thoracic drainage tube indwelling time 2d～4d（3±1）d，postoperative hospitalization time 5～7 d（6±1）d，1 cases of postoperative patients with generalized subcutaneous emphysema，1 cases of patients with pleural effusion，all patients were followed up for 3 months to 6 months without recurrence of pneumothorax.Conclusion Compared with traditional thoracoscopic surgery，modified single-hole thoracoscopic surgery for spontaneous pneumothorax has the advantages of less trauma， fewer incision and fewer complications.The modified procedure is safe and feasible，and the curative effect is reliable. Key words：Single hole video-assisted thoracoscopic surgery；Spontaneous pneumothorax；Modified operation 自?l性气胸是一种常见的胸外科疾病，好发于青少年，尤其是男性，主要为肺大疱破裂所致，并被定义为胸腔内存在气体。据统计约10%～20%的自发性气胸患者需要手术治疗[1]。随着微创技术的发展，自发性气胸的手术治疗由传统的小切口开胸手术，逐渐发展为传统的三孔胸腔镜手术及两孔胸腔镜手术，目前单孔胸腔镜手术（即观察孔、 操作孔、 胸管引流孔三孔合一）开始逐渐应用于自发性气胸的的