【摘要】：目的 :比較開胸肺葉切除術(shù)和胸腔鏡肺葉切除術(shù)兩種手術(shù)方式在治療葉內(nèi)型肺隔離癥的應(yīng)用,總結(jié)胸腔鏡手術(shù)在治療葉內(nèi)型肺隔離癥中的經(jīng)驗(yàn)。方法:回顧性分析2000年3月—2015年6月南京醫(yī)科大學(xué)第一附屬醫(yī)院胸外科收治的36例葉內(nèi)型肺隔離癥的臨床資料。分為開胸手術(shù)組和胸腔鏡手術(shù)(video-assisted thoracoscopic surgery,VATS)組。對兩組手術(shù)時間、術(shù)中出血量、術(shù)后引流、術(shù)后住院日以及術(shù)后并發(fā)癥等進(jìn)行分析。結(jié)果:手術(shù)切除右肺下葉14例,左肺下葉21例,左肺下葉+左肺上葉舌段1例。開胸手術(shù)組23例,VATS組13例(無中轉(zhuǎn)開胸手術(shù))。VATS組與開胸組相比出血量(P=0.007)、術(shù)后胸管留置時間(P=0.039)和術(shù)后住院時間(P=0.004)的差異有統(tǒng)計(jì)學(xué)意義。兩組手術(shù)時間(P=0.202)、術(shù)后引流量(P=0.591)和術(shù)后并發(fā)癥(P=0.682)差異無統(tǒng)計(jì)學(xué)意義。無圍手術(shù)期死亡,36例患者均治愈出院。36例患者中,術(shù)后失訪5例,其余31例隨訪6個月~15年,患者均恢復(fù)良好。結(jié)論:胸腔鏡肺葉切除術(shù)治療葉內(nèi)型肺隔離癥安全有效。
[Abstract]:Objective: to compare the application of thoracoscopic lobectomy and thoracoscopic lobectomy in the treatment of intralobar pulmonary sequestration, and summarize the experience of thoracoscopic surgery in the treatment of intralobar pulmonary sequestration. Methods: the clinical data of 36 cases of pulmonary sequestration in the first affiliated Hospital of Nanjing Medical University from March 2000 to June 2015 were retrospectively analyzed. The patients were divided into thoracotomy group and video-assisted thoracoscopic surgery vats group. The operative time, blood loss, postoperative drainage, postoperative hospital stay and postoperative complications were analyzed. Results: 14 cases of right lower lobe were resected, 21 cases of left lower lobe and 1 case of left lower lobe of left upper lobe. There were significant differences in blood loss (P0. 007), postoperative chest tube indwelling time (P0. 039) and postoperative hospitalization time (P0. 004) between vats group and thoracotomy group. There was no significant difference between the two groups in the time of operation (P0. 202), postoperative drainage (P0. 591) and postoperative complications (P0. 682). Of the 36 patients with no perioperative death, 5 had lost access and 31 had been followed up for 6 months to 15 years. All patients recovered well. Conclusion: thoracoscopic lobectomy is safe and effective in the treatment of intralobar pulmonary sequestration.
【作者單位】： 南京醫(yī)科大學(xué)第一附屬醫(yī)院胸外科;
【基金】：江蘇省衛(wèi)生廳面上科研課題(H201303)
【分類號】：R655.3

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