本文選題：原發(fā)性自發(fā)性氣胸 + 電視胸腔鏡手術(shù)　； 參考：《延邊大學(xué)》2017年碩士論文

【摘要】：目的分析單孔牽引法、兩孔法和單孔法胸腔鏡手術(shù)治療原發(fā)性自發(fā)性氣胸的臨床療效。方法選取我院2014年05月—2016年10月間經(jīng)胸腔鏡手術(shù)的原發(fā)性自發(fā)性氣胸226例,根據(jù)治療方法的不同分為兩孔法組(166例)、單孔法組(20例)及單孔牽引法組(40例),分析三組平均手術(shù)時(shí)間、麻醉時(shí)間、出血量、術(shù)后引流量、帶管時(shí)間、住院天數(shù)、疼痛評(píng)分、住院費(fèi)用和復(fù)發(fā)率等,比較兩孔法、單孔法與單孔牽引法之間是否存在統(tǒng)計(jì)學(xué)差異性。結(jié)果本研究中男性204例,女性22例,男女比例10:1;漢族147例,朝鮮族68例,其他11例,比例為13:6:1;首次發(fā)作210例,多次發(fā)作16例,比例為14:1;疼痛程度中輕度118例,中度100例,重度8例,比例為15:12:1;所有對(duì)象隨訪期內(nèi)復(fù)發(fā)1例,為兩孔法組。單孔牽引法手術(shù)時(shí)間與兩孔法比較(42.8±16.2vs37.3±12.5),差異有統(tǒng)計(jì)學(xué)意義(p0.05),而和單孔法(47.4±11.9)比較差異無(wú)統(tǒng)計(jì)學(xué)意義;單孔牽引法出血量與兩孔法比較(20.26±9.44 vs38.51±13.34),差異有統(tǒng)計(jì)學(xué)意義(p0.05),單孔牽引法出血量與單孔法比較(20.26±9.44 vs 15.52±1.57),差異有統(tǒng)計(jì)學(xué)意義(p0.05);單孔牽引法疼痛評(píng)分與兩孔法比較(3.18±1.15 vs3.90±1.45),差異有統(tǒng)計(jì)學(xué)意義(p0.05),而和單孔法比較(2.95±1.13)比較差異無(wú)統(tǒng)計(jì)學(xué)意義;三組間麻醉時(shí)間、術(shù)后1日引流量、帶管時(shí)間、住院天數(shù)和住院費(fèi)用比較差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論1.單孔牽引法VATS治療原發(fā)性自發(fā)性氣胸可以取得與兩孔法、單孔法相同的治療效果。2.單孔牽引法VATS治療原發(fā)性自發(fā)性氣胸具有安全、可靠及術(shù)后疼痛輕的優(yōu)點(diǎn),熟練后可縮短手術(shù)時(shí)間,效果更佳,值得在臨床治療自發(fā)性氣胸中推廣應(yīng)用。3.牽引輔助法可用于肺腫瘤局部切除、肺活檢等更多胸腔鏡手術(shù)。
[Abstract]:Objective to analyze the clinical effect of single-hole traction, two-hole and one-hole thoracoscopy in the treatment of primary spontaneous pneumothorax. Methods 226 patients with primary spontaneous pneumothorax who underwent thoracoscopic surgery from May 2014 to October 2016 were selected. According to the different treatment methods, the patients were divided into two hole group (166 cases), one hole group (20 cases) and one hole traction group (40 cases). The cost of hospitalization and recurrence rate were compared between the two hole method, single hole method and single hole traction method. Results in this study, 204 males, 22 females, 10: 1 male / female ratio, 147 Han nationality, 68 Korean, 11 others (13: 6: 1), 210 cases of first episode, 16 cases of multiple episodes (14: 1), 118 cases of mild pain, 100 cases of moderate pain, There were 8 severe cases (15: 12: 1) and 1 case of recurrence in all subjects during the follow-up period. The operative time of single-hole traction method was significantly different from that of two-hole method (42.8 鹵16.2vs37.3 鹵12.5), but there was no significant difference compared with single-hole method (47.4 鹵11.9). The amount of bleeding in the single hole traction method was significantly higher than that in the single hole traction method (20.26 鹵9.44 vs38.51 鹵13.34), and the single hole traction method was significantly higher than the single hole method (20.26 鹵9.44 vs 15.52 鹵1.57, p0.05), and the pain score of the single-hole traction method was (3.18 鹵1.15 vs3.90 鹵1.45) compared with that of the two-hole method (p0.05), which was significantly different from that of the single-hole traction method (20.26 鹵9.44 vs 15.52 鹵1.57) and the single-hole traction method (3.18 鹵1.15 vs3.90 鹵1.45). There was statistical significance (p0.05), but there was no significant difference compared with single-hole method (2.95 鹵1.13). There was no significant difference between the three groups in anesthetic time, postoperative drainage, tube length, hospitalization days and hospitalization expenses. Conclusion 1. The treatment of primary spontaneous pneumothorax with single hole traction method vats can achieve the same effect as that of two hole method and one hole method. The treatment of primary spontaneous pneumothorax by single hole traction method vats has the advantages of safety, reliability and light postoperative pain. It can shorten the operation time after being skilled, and the effect is better. It is worth popularizing and applying in clinical treatment of spontaneous pneumothorax. Traction-assisted surgery can be used for local resection of lung tumors, lung biopsy and more thoracoscopic surgery.
【學(xué)位授予單位】：延邊大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R561.4

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本文編號(hào)：2106893