中国医师进修杂志
中國醫師進脩雜誌
중국의사진수잡지
CHINESE JOURNAL OF POSTGRADUATES OF MEDICINE
2012年
14期
17-19
,共3页
窦万强%胡敦蓉%朱利伟%苏瑞婷%王洋
竇萬彊%鬍敦蓉%硃利偉%囌瑞婷%王洋
두만강%호돈용%주리위%소서정%왕양
胸腔镜%腹腔镜%诊断%治疗%胸腹联合伤
胸腔鏡%腹腔鏡%診斷%治療%胸腹聯閤傷
흉강경%복강경%진단%치료%흉복연합상
Thoracoscopes%Laparoscopes%Diagnosis%Therapy%Thoracoabdominal injuries
目的 探讨完全胸腔镜联合腹腔镜诊治胸腹联合伤的可行性和疗效.方法 回顾性分析2007年3月至2011年3月采用完全胸腔镜联合腹腔镜治疗36例胸腹联合伤患者(腔镜组)的临床资料,并与同时期接受传统标准手术治疗的36例患者(传统组)对照,比较术中及术后情况.结果 腔镜组患者均经过腔镜手术顺利完成,无手术死亡病例,无膈疝、迟发性血气胸等与手术相关的并发症.腔镜组手术时间(98±38) min、术中出血量(120±45) ml、术后24 h引流量(230±55)ml、术后引流管留置时间(5±2)d、术后72 h疼痛VAS评分(3.31±0.87)分、住院费用(1.23±0.76)万元、术后肠功能恢复时间( 2.29±1.02)d、住院时间(10±3)d,传统组分别为(135±31) min、(220±30)ml、(400±160)ml、(9±3)d、(6.82±1.67)分、(2.34±0.85)万元、(5.46±2.31)d、(16±2)d,两组比较差异均有统计学意义(P＜0.05)；腔镜组术后心肺并发症发生率11.1％(4/36),传统组为13.9％(5/36),两组比较差异无统计学意义(P＞0.05).结论 完全胸腔镜联合腹腔镜同步诊治胸腹联合伤,安全、创伤小、住院时间短、花费少、疗效可靠,值得临床推广应用.
目的 探討完全胸腔鏡聯閤腹腔鏡診治胸腹聯閤傷的可行性和療效.方法 迴顧性分析2007年3月至2011年3月採用完全胸腔鏡聯閤腹腔鏡治療36例胸腹聯閤傷患者(腔鏡組)的臨床資料,併與同時期接受傳統標準手術治療的36例患者(傳統組)對照,比較術中及術後情況.結果 腔鏡組患者均經過腔鏡手術順利完成,無手術死亡病例,無膈疝、遲髮性血氣胸等與手術相關的併髮癥.腔鏡組手術時間(98±38) min、術中齣血量(120±45) ml、術後24 h引流量(230±55)ml、術後引流管留置時間(5±2)d、術後72 h疼痛VAS評分(3.31±0.87)分、住院費用(1.23±0.76)萬元、術後腸功能恢複時間( 2.29±1.02)d、住院時間(10±3)d,傳統組分彆為(135±31) min、(220±30)ml、(400±160)ml、(9±3)d、(6.82±1.67)分、(2.34±0.85)萬元、(5.46±2.31)d、(16±2)d,兩組比較差異均有統計學意義(P＜0.05)；腔鏡組術後心肺併髮癥髮生率11.1％(4/36),傳統組為13.9％(5/36),兩組比較差異無統計學意義(P＞0.05).結論 完全胸腔鏡聯閤腹腔鏡同步診治胸腹聯閤傷,安全、創傷小、住院時間短、花費少、療效可靠,值得臨床推廣應用.
목적 탐토완전흉강경연합복강경진치흉복연합상적가행성화료효.방법 회고성분석2007년3월지2011년3월채용완전흉강경연합복강경치료36례흉복연합상환자(강경조)적림상자료,병여동시기접수전통표준수술치료적36례환자(전통조)대조,비교술중급술후정황.결과 강경조환자균경과강경수술순리완성,무수술사망병례,무격산、지발성혈기흉등여수술상관적병발증.강경조수술시간(98±38) min、술중출혈량(120±45) ml、술후24 h인류량(230±55)ml、술후인류관류치시간(5±2)d、술후72 h동통VAS평분(3.31±0.87)분、주원비용(1.23±0.76)만원、술후장공능회복시간( 2.29±1.02)d、주원시간(10±3)d,전통조분별위(135±31) min、(220±30)ml、(400±160)ml、(9±3)d、(6.82±1.67)분、(2.34±0.85)만원、(5.46±2.31)d、(16±2)d,량조비교차이균유통계학의의(P＜0.05)；강경조술후심폐병발증발생솔11.1％(4/36),전통조위13.9％(5/36),량조비교차이무통계학의의(P＞0.05).결론 완전흉강경연합복강경동보진치흉복연합상,안전、창상소、주원시간단、화비소、료효가고,치득림상추엄응용.
Objective To investigate the feasibility and effect of complete thoacoscopes and laparoscopes combination operation for thoracoabdominal injuries.Methods From March 2007 to March 2011,the clinical data of 36 patients (observation group) with thoracoabdominal injuries who were performed with complete thoracoscopes and laparoscopes combination operation were analyzed retrospectively,and compared with 36 patients (control group) treated with traditional standard operation in the same period.The intraoperative and postoperative situation was compared between two groups.Results All the patients in observation group were successfully performed by complete endoscopic surgery.There were no operative mortality and complications related to operation,such as diaphragmatic hernia,delayed hemopneumothorax.The operative time of observation group was (98 ±38 ) min,operative blood loss was ( 120±45 ) ml,drainage flow within 24 h was (230 ±55) ml,drainage tube duration was (5 ±2) d,postoperative pain vasual analogue scale (VAS) score was (3.31±0.87) scores,hospitalization cost was ( 1 2.3±7.6) thousand yuan,postoperative recovery time of intestinal function was (2.29±1.02) d,hospital stay was ( 10±3 ) d.Those values of control group were respectively ( 135±31 ) min,(220±30) ml,(400±160) ml,(9±3) d,(6.82±1.67) scores,(23.4±8.5) thousand yuan,(5.46 ±2.31 ) d and ( 16±2) d.There were significant differences between two groups (P ＜0.05).The occurrence rate of cardiopulmonary complication of observation group [ 11.1％(4/36) ] and control group [ 13.9％(5/36) ] had no significant difference (P＞0.05).Conclusions Complete thoracoscopes and laparoscopes combination operation for thoracoabdominal injuries is a safe and mini-invasive treatment with quicker recovery,less cost and more reliable effect.Therefore,it deserves further clinical application.
