改良單孔胸腔鏡手術治療自發(fā)性氣胸臨床研究
發(fā)布時間：2019-01-08 10:22
【摘要】：[研究背景及目的]:手術微創(chuàng)化是現(xiàn)代外科的重要標識,近年隨著科學技術及醫(yī)療技術的飛速發(fā)展,胸腔鏡手術廣泛運用于胸科疾病的診療。自發(fā)氣胸的外科手術方式既往為開胸肺大皰切除,電凝,縫扎術,但創(chuàng)傷大,并發(fā)癥較多,術后患者疼痛較重。胸腔鏡的發(fā)展使手術方式轉變?yōu)槿?雙孔胸腔鏡下肺大皰切除術。隨著胸外科醫(yī)生臨床經(jīng)驗的積累,為更減少患者切口疼痛,單孔胸腔鏡被運用于自發(fā)性氣胸的手術治療中。為探討改良單孔胸腔鏡手術治療自發(fā)性氣胸的可行性及療效,我科運用改良的單孔胸腔鏡手術(即觀察孔、操作孔合二為一加微管引流)診治自發(fā)性氣胸患者,并分析加以討論。[方法]:在傳統(tǒng)胸腔鏡手術基礎上,應用改良的單孔胸腔鏡手術(即單操作孔加微管引流)治療我科收治42例自發(fā)性氣胸患者,并分析術后各項臨床指標,如:手術時間、胸腔閉式引流量、術中失血量、術后胸腔閉式引流管留置時間、術后住院時間等,并觀察患者術后療效及手術的可行性。[結果]:42例患者均在改良單孔胸腔鏡下行肺大皰切除術,手術時間40min-70min,平均 55min±15min,胸腔閉式引流量 150ml-430ml,平均 290ml±140ml,術中失血量為10-20ml(15±5)ml,術后胸腔閉式引流管留置時間2d-4d(3± 1)d,術后住院時間5-7天(6±1)d,術后1例患者并發(fā)全身廣泛皮下氣腫,1例患者并發(fā)胸腔積液,所有患者隨訪3月-6月,未出現(xiàn)氣胸復發(fā)。[結論]:與傳統(tǒng)胸腔鏡手術相比,改良的單孔胸腔鏡手術治療自發(fā)性氣胸,具有創(chuàng)傷更小,切口數(shù)目更少及并發(fā)癥少、手術切口更美觀,患者術后疼痛更輕,住院時間更短、更微創(chuàng)化等優(yōu)點,該改良術式安全可行,療效可靠。
[Abstract]:Background and objective: surgical minimally invasive surgery is an important mark of modern surgery. With the rapid development of science and technology and medical technology in recent years, thoracoscopic surgery is widely used in the diagnosis and treatment of chest diseases. The surgical methods of spontaneous pneumothorax were open pneumonectomy, electric coagulation and suture ligation, but the trauma was great, the complications were more, and the postoperative pain was more serious. The development of thoracoscopy changed the operation into three-hole, double-hole thoracoscopic pneumonectomy. With the accumulation of clinical experience of thoracic surgeons, in order to reduce incision pain, single-hole thoracoscopy is used in the surgical treatment of spontaneous pneumothorax. In order to investigate the feasibility and efficacy of modified thoracoscopic surgery for spontaneous pneumothorax, we used modified thoracoscopic surgery (i.e., observation hole, combined with microtubule drainage) to treat patients with spontaneous pneumothorax. And analyzed and discussed. [methods] on the basis of traditional thoracoscopic surgery, 42 patients with spontaneous pneumothorax were treated with modified thoracoscopic surgery (single hole plus microtubule drainage). The closed drainage of thoracic cavity, the amount of blood lost during operation, the time of indwelling closed drainage tube and the time of hospitalization after operation were observed. The curative effect and the feasibility of operation were observed. [results]: 42 patients underwent pulmonary bullous resection under modified thoracoscopic surgery. The operative time was 40 min-70 min (mean 55min 鹵15 min), the closed thoracic drainage volume was 150ml-430ml (290ml 鹵140ml), and the amount of blood lost during operation was (15 鹵5) ml,. The time of indwelling closed drainage tube in thoracic cavity after operation was (3 鹵1) days, the postoperative hospitalization time was (5 鹵1) days (6 鹵1) days, one patient was complicated with extensive subcutaneous emphysema and one patient was complicated with pleural effusion. All the patients were followed up from 3 to 6 months. There was no recurrence of pneumothorax. [conclusion] compared with the traditional thoracoscopic surgery, the modified thoracoscopic surgery for spontaneous pneumothorax has less trauma, fewer incisions, fewer complications, more beautiful incisions, lighter postoperative pain and shorter hospital stay. More minimally invasive and other advantages, the improved operation is safe and feasible, the efficacy is reliable.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R655
本文編號：2404475
[Abstract]:Background and objective: surgical minimally invasive surgery is an important mark of modern surgery. With the rapid development of science and technology and medical technology in recent years, thoracoscopic surgery is widely used in the diagnosis and treatment of chest diseases. The surgical methods of spontaneous pneumothorax were open pneumonectomy, electric coagulation and suture ligation, but the trauma was great, the complications were more, and the postoperative pain was more serious. The development of thoracoscopy changed the operation into three-hole, double-hole thoracoscopic pneumonectomy. With the accumulation of clinical experience of thoracic surgeons, in order to reduce incision pain, single-hole thoracoscopy is used in the surgical treatment of spontaneous pneumothorax. In order to investigate the feasibility and efficacy of modified thoracoscopic surgery for spontaneous pneumothorax, we used modified thoracoscopic surgery (i.e., observation hole, combined with microtubule drainage) to treat patients with spontaneous pneumothorax. And analyzed and discussed. [methods] on the basis of traditional thoracoscopic surgery, 42 patients with spontaneous pneumothorax were treated with modified thoracoscopic surgery (single hole plus microtubule drainage). The closed drainage of thoracic cavity, the amount of blood lost during operation, the time of indwelling closed drainage tube and the time of hospitalization after operation were observed. The curative effect and the feasibility of operation were observed. [results]: 42 patients underwent pulmonary bullous resection under modified thoracoscopic surgery. The operative time was 40 min-70 min (mean 55min 鹵15 min), the closed thoracic drainage volume was 150ml-430ml (290ml 鹵140ml), and the amount of blood lost during operation was (15 鹵5) ml,. The time of indwelling closed drainage tube in thoracic cavity after operation was (3 鹵1) days, the postoperative hospitalization time was (5 鹵1) days (6 鹵1) days, one patient was complicated with extensive subcutaneous emphysema and one patient was complicated with pleural effusion. All the patients were followed up from 3 to 6 months. There was no recurrence of pneumothorax. [conclusion] compared with the traditional thoracoscopic surgery, the modified thoracoscopic surgery for spontaneous pneumothorax has less trauma, fewer incisions, fewer complications, more beautiful incisions, lighter postoperative pain and shorter hospital stay. More minimally invasive and other advantages, the improved operation is safe and feasible, the efficacy is reliable.
【學位授予單位】：昆明醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R655
【參考文獻】
相關期刊論文 前9條
1 金璐明;黃宇清;陳應泰;崔健;劉軍;;單操作孔法與傳統(tǒng)雙操作孔法治療自發(fā)性氣胸的對比性研究[J];廣西醫(yī)學;2014年06期
2 車國衛(wèi);劉倫旭;;單孔電視胸腔鏡手術臨床應用的現(xiàn)狀與進展[J];中國胸心血管外科臨床雜志;2012年02期
3 范曉燕;高榴益;王利明;;羅哌卡因復合芬太尼肋間神經(jīng)阻滯麻醉效果及對術后鎮(zhèn)痛的影響[J];臨床麻醉學雜志;2011年10期
4 蒲振業(yè);陳亮;朱全;潘世揚;秦雪君;;完全胸腔鏡與開放性肺葉切除術治療的非小細胞肺癌患者圍手術期IGFBP-3、VEGF、IL-6水平的比較[J];南京醫(yī)科大學學報(自然科學版);2011年07期
5 嵇武;胡新勇;黎介壽;;手術機器人的應用進展與前景展望[J];醫(yī)學研究生學報;2010年09期
6 王俊;劉彥國;;胸腔鏡外科——傳統(tǒng)胸外科之“升級版”[J];中國微創(chuàng)外科雜志;2010年02期
7 魏云煒;羅清泉;;全胸腔鏡下肺葉切除治療肺癌[J];腫瘤;2009年05期
8 王俊;電視胸腔鏡在胸部疾病治療中的應用現(xiàn)狀[J];臨床外科雜志;2005年06期
9 何建行,楊運有,陳滿蔭,韋兵,殷偉強,曾侖;雙側胸腔同期一次胸腔鏡手術33例[J];中華胸心血管外科雜志;1997年04期
，本文編號：2404475
本文鏈接：http://sikaile.net/yixuelunwen/jjyx/2404475.html
最近更新
教材專著
