發(fā)布時間：2018-08-30 20:46

【摘要】：目的：探討胸腔鏡同期治療對側肺大皰的療效。方法：回顧分析新疆醫(yī)科大學第一附屬醫(yī)院2011年3月至2013年4月所有行手術治療的160例肺大皰患者的臨床資料,根據(jù)肺大皰所在部位及手術部位分為A、B、C三組。A組：108例自發(fā)性氣胸患者無對側肺大皰而接受單側胸腔鏡肺大皰切除術；B組：40例自發(fā)性氣胸患者有雙側肺大皰,但只接受單側胸腔鏡肺大皰切除術；C組：12例自發(fā)性氣胸患者患雙側肺大皰,同期行雙側胸腔鏡肺大皰切除術。分析三組患者對側氣胸發(fā)生率及急性肺水腫、胸腔粘連、呼吸衰竭、術后肺漏氣等并發(fā)癥的發(fā)生率。結果：隨訪20個月,A組：術后發(fā)生急性肺水腫1例(0.9%),胸腔粘連11例(10.19%),呼吸衰竭2例(1.86%),術后漏氣5例(4.62%)。隨訪期間對側發(fā)生自發(fā)性氣胸3例(2.78%)。B組：術后發(fā)生胸腔粘連4例(10.00%),呼吸衰竭1例(2.50%),術后漏氣3例(7.50%)。對側發(fā)生自發(fā)性氣胸15例(37.50%)。C組：術后發(fā)生胸腔粘連2例(16.67%),術后漏氣1例(8.33%)。隨訪期間無對側自發(fā)性氣胸的發(fā)生。結論：同期電視胸腔鏡手術預防性治療對側肺大皰,療效滿意,安全可靠,能有效預防對側氣胸的發(fā)生。
[Abstract]:Objective: to evaluate the efficacy of thoracoscopic treatment of contralateral pulmonary bullae. Methods: the clinical data of 160 patients with pulmonary bullae treated in the first affiliated Hospital of Xinjiang Medical University from March 2011 to April 2013 were retrospectively analyzed. According to the location of pulmonary bullae and the site of operation, group A was divided into group A (n = 108) and group A (n = 108) without contralateral pneumothorax. Group B (n = 40) received unilateral thoracoscopic pneumonectomy and group B (n = 40) had bilateral pulmonary bullous pneumothorax. But only unilateral thoracoscopic pneumonectomy was performed in group C: 12 patients with spontaneous pneumothorax suffered from bilateral bullous pneumothorax and bilateral thoracoscopic bullous pneumonectomy was performed at the same time. The incidence of contralateral pneumothorax, acute pulmonary edema, thoracic adhesion, respiratory failure and postoperative lung leakage were analyzed. Results: in group A, acute pulmonary edema occurred in 1 case (0.9%), thoracic adhesion in 11 cases (10.19%), respiratory failure in 2 cases (1.86%) and air leakage in 5 cases (4.62%). Spontaneous pneumothorax occurred in 3 cases (2.78%) in the contralateral pneumothorax. Group B: thoracic adhesion occurred in 4 cases (10.00%), respiratory failure in 1 case (2.50%), and postoperative air leakage in 3 cases (7.50%). There were 15 cases (37.50%) with spontaneous pneumothorax on the contralateral side. In group C, thoracic adhesion occurred in 2 cases (16.67%) and air leakage in 1 case (8.33%). There was no contralateral spontaneous pneumothorax during follow-up. Conclusion: the prophylactic treatment of contralateral pulmonary bullae by video-assisted thoracoscopic surgery is satisfactory, safe and reliable, and can effectively prevent the occurrence of contralateral pneumothorax.
【學位授予單位】：新疆醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2015
【分類號】：R655.3

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