【摘要】：目的探討經(jīng)劍突下切口胸腔鏡同期治療雙側(cè)肺大皰的臨床價值。方法 2014年1月~2016年1月我院對30例雙側(cè)肺大皰采用單孔胸腔鏡同期手術(shù),劍突下4 cm切口作為單孔,將胸腔鏡置入病變較重側(cè)胸腔后,尋找到肺大皰,對基底直徑0.5 cm大皰直接電棒燒灼;基底直徑0.5~2 cm大皰Hem-o-lok夾閉或切除后縫扎處理;基底直徑2 cm的片狀肺大皰用Endo-GIA切除。一側(cè)手術(shù)完成后,再經(jīng)單孔將胸腔鏡置入對側(cè)胸腔,同法完成對側(cè)手術(shù)。結(jié)果術(shù)中出血量(53.1±17.6)ml,手術(shù)時間(105.6±20.3)min,術(shù)后胸管留置時間(6.3±2.5)d,術(shù)后住院時間(8.9±2.6)d。術(shù)后肺漏氣2例,經(jīng)胸腔沖洗后治愈。30例術(shù)后隨訪3~12個月,平均7.6月,均無復(fù)發(fā)。結(jié)論經(jīng)劍突下切口單孔胸腔鏡同期手術(shù)治療雙側(cè)肺大皰安全、可靠。
[Abstract]:Objective to evaluate the clinical value of thoracoscopic treatment of bilateral pulmonary bullae through subscleral incision. Methods from January 2014 to January 2016, 30 patients with bilateral bullae were treated with single hole thoracoscopic surgery, 4 cm incision under the sword process was used as the single hole, and the bullae of lung was found after placement of thoracoscope on the heavier side of the lesion. Direct electric rod cauterization of basal diameter 0.5 cm bullous; The basal diameter of 0.5 ~ 2 cm bullous Hem-o-lok was occluded or sutured after resection, and the lamellar pulmonary bullae with 2 cm basal diameter was resected by Endo-GIA. After unilateral operation, the thoracoscopy was placed into the contralateral thoracic cavity, and the contralateral operation was performed with the same method. Results the intraoperative bleeding volume was (53.1 鹵17.6) ml, operation time was (105.6 鹵20.3) min, postoperative chest tube indwelling time was (6.3 鹵2.5) days, postoperative hospitalization time was (8.9 鹵2.6) days. Pulmonary leakage was cured in 2 cases after operation, 30 cases were followed up for 3 ~ 12 months (mean 7.6 months), no recurrence was found. Conclusion it is safe and reliable to treat bilateral pulmonary bullae with single-hole thoracoscopy via subdractory incision.
【作者單位】： 曲靖市第一人民醫(yī)院胸心外科;
【分類號】：R655.3

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