本文選題：自發(fā)性氣胸 + 單孔胸腔鏡手術(shù)　； 參考：《中國(guó)微創(chuàng)外科雜志》2016年11期

【摘要】：目的比較單孔法與雙孔法胸腔鏡肺大皰切除術(shù)治療自發(fā)性氣胸的療效。方法回顧性分析我院2013年5月~2014年4月109例單側(cè)自發(fā)性氣胸的臨床資料,其中單孔組59例,雙孔組50例,比較2組手術(shù)時(shí)間、術(shù)中出血量、術(shù)后總胸腔引流量、術(shù)后胸腔引流管留置時(shí)間、術(shù)后住院時(shí)間、并發(fā)癥發(fā)生率、圍手術(shù)期死亡率和術(shù)后疼痛評(píng)分。結(jié)果 2組均順利完成手術(shù),無(wú)中轉(zhuǎn)開(kāi)胸及圍手術(shù)期死亡。2組手術(shù)時(shí)間無(wú)明顯差異[(57.7±21.5)min vs.(60.3±26.8)min,t=-0.562,P=0.575];單孔組術(shù)中出血量中位數(shù)明顯少于雙孔組(10 ml vs.20 ml,Z=-2.411,P=0.016);單孔組術(shù)后總胸腔引流量中位數(shù)明顯少于雙孔組(110 ml vs.312 ml,Z=-5.168,P=0.000);單孔組術(shù)后胸腔引流管留置時(shí)間明顯短于雙孔組[(2.8±0.9)d vs.(4.2±2.8)d(t=-3.628,P=0.000];單孔組術(shù)后住院時(shí)間明顯短于雙孔組[(3.7±1.1)d vs.(4.7±3.0)d,t=-2.380,P=0.019];單孔組術(shù)后NRS法疼痛評(píng)分明顯小于雙孔組[(3.3±1.5)分vs.(4.8±1.6)分,t=-5.046,P=0.000]。2組各發(fā)生肺部漏氣1例。2組患者術(shù)后1、3、6、12個(gè)月定期隨訪,隨訪12個(gè)月,無(wú)氣胸復(fù)發(fā)。結(jié)論單孔法與常規(guī)雙孔法胸腔鏡肺大皰切除術(shù)治療自發(fā)性氣胸,療效相當(dāng),在技術(shù)上是安全、可行的,單孔法疼痛更輕,恢復(fù)更快,更具有微創(chuàng)優(yōu)勢(shì)。
[Abstract]:Objective to compare the effect of thoracoscopic bullous excision with one hole method and two-hole method in the treatment of spontaneous pneumothorax. Methods the clinical data of 109 cases of unilateral spontaneous pneumothorax in our hospital from May 2013 to April 2014 were analyzed retrospectively, including 59 cases in single hole group and 50 cases in double hole group. Postoperative thoracic drainage tube indwelling time, postoperative hospitalization time, incidence of complications, perioperative mortality and postoperative pain score. Results the operation was successfully completed in both groups. There was no significant difference in the operative time between the two groups (57.7 鹵21.5) min vs. (60.3 鹵26.8), the median of intraoperative bleeding in the single hole group was significantly lower than that in the double hole group (10 ml / ml vs.20 / ml ZAL-2.411P 0.016), and the median of postoperative total thoracic drainage volume in the single hole group was significantly lower than that in the double hole group (110ml / ml). The time of intrathoracic drainage in the single hole group was significantly shorter than that in the double hole group [(2.8 鹵0.9) d vs. (4.2 鹵2.8) d (t ~ (-3.628) P ~ 0.000]; the hospitalization time in the single hole group was significantly shorter than that in the double-hole group [(3.7 鹵1.1) d vs. (4.7 鹵3.0) days]; the pain score in the single hole group was significantly lower than that in the double-hole group [(3.3 鹵1.5) vs (4.8 鹵1.6) min vs 0.000]. The postoperative pain scores in the single hole group were significantly lower than those in the double-hole group [(3.3 鹵1.5) vs (4.8 鹵1.6) min vs 5.046P 0.000]. Pulmonary leakage occurred in 1 case of group 2. 6 cases were followed up regularly for 12 months. No recurrence of pneumothorax was found after 12 months follow-up. Conclusion the treatment of spontaneous pneumothorax with single hole method and double hole thoracoscopic bullous excision is effective, safe and feasible. The single hole method has the advantages of less pain, faster recovery and more minimally invasive.
【作者單位】： 四川省醫(yī)學(xué)科學(xué)院四川省人民醫(yī)院胸外科;
【分類(lèi)號(hào)】：R655.3

【相似文獻(xiàn)】

相關(guān)期刊論文 前10條

1 馬力;謝宜旭;郭申杰;;肺大皰切除術(shù)外科技術(shù)體會(huì)[J];河南外科學(xué)雜志;2008年05期

2 蘇燕芬;;胸腔鏡輔助下肺大皰切除術(shù)的護(hù)理干預(yù)[J];蛇志;2010年02期

3 王敏芳;鄭麗嬌;;胸腔鏡下雙側(cè)肺大皰切除術(shù)后并發(fā)心肌梗死患者的護(hù)理[J];吉林醫(yī)學(xué);2011年12期

4 柯碧琴;林秀娟;方秀香;;電視胸腔鏡肺大皰切除術(shù)的護(hù)理[J];中國(guó)醫(yī)藥指南;2012年23期

5 劉晨;劉文輝;陳志全;李小勇;石桂葆;李秀榮;劉信榮;;肺大皰切除術(shù)后并發(fā)癥預(yù)防[J];臨床肺科雜志;2013年01期

6 張玉謙;;胸腔鏡輔助小切口行肺大皰切除術(shù)治療自發(fā)性氣胸圍術(shù)期護(hù)理觀察[J];實(shí)用心腦肺血管病雜志;2013年01期

7 邢美麗,程麥鐲,馬甜;胸腔鏡下肺大皰切除術(shù)43例護(hù)理體會(huì)[J];陜西醫(yī)學(xué)雜志;2005年09期

8 林菊珍;鄭秀娥;黃錦蘭;;電視胸腔鏡下肺大皰切除術(shù)的配合[J];吉林醫(yī)學(xué);2010年05期

9 吳小勤;尹海軍;張廣云;劉漢云;;肺大皰切除術(shù)后復(fù)發(fā)氣胸的處理[J];中國(guó)實(shí)用醫(yī)藥;2012年24期

10 全鳳瓊;楊楠;鄧雪麗;蘇飛雪;張力;;膨肺吸痰法在胸腔鏡下肺大皰切除術(shù)患者中的應(yīng)用[J];西部醫(yī)學(xué);2012年10期

相關(guān)會(huì)議論文 前1條

1 黃業(yè)鳳;;胸腔鏡輔助下肺大皰切除術(shù)患者的護(hù)理[A];全國(guó)外科護(hù)理學(xué)術(shù)交流暨專(zhuān)題講座會(huì)議論文匯編[C];2008年

相關(guān)碩士學(xué)位論文 前1條

1 靳明揚(yáng);劍突下單孔胸腔鏡肺大皰切除術(shù)的臨床病例分析[D];山東大學(xué);2015年

，

本文編號(hào)：2050518