CAJ | 학술논문

背景：有学者认为对于易复发的原发性自发性气胸应积极行胸腔镜手术治疗，并且术中行胸膜固定能有效降低术后复发率。 　　目的：探讨安尔碘法胸腔镜治疗原发性自发性气胸的可靠性及有效性。 　　方法：纳入原发性自发性气胸患者64例，其中男46例，女18例，年龄15-30岁，随机均分为试验组与对照组，两组均进行胸腔镜手术治疗，其中试验组关闭切口前应用干纱布蘸取安尔碘涂抹整个胸腔，对照组未应用安尔碘。比较两组患者的手术时间、术中出血、术后引流量、术后漏气时间，术后拔管时间、术后并发症发病率及术后1年气胸的复发率。 　　结果与结论：两组手术时间、术中出血、术后漏气时间、术后拔除胸管时间及术后并发症的发生率比较差异均无显著性意义(P >0.05)；试验组术后引流量较对照组明显增加(P <0.05)，但未造成需医学干预的后果；试验组术后1年复发率低于对照组(P<0.05)。结果表明胸腔镜手术过程中利用安尔碘涂擦壁层胸膜行胸膜固定，是一种预防原发性自发性气胸术后气胸复发的可靠且有效的治疗方式。
배경：유학자인위대우역복발적원발성자발성기흉응적겁행흉강경수술치료，병차술중행흉막고정능유효강저술후복발솔。 　　목적：탐토안이전법흉강경치료원발성자발성기흉적가고성급유효성。 　　방법：납입원발성자발성기흉환자64례，기중남46례，녀18례，년령15-30세，수궤균분위시험조여대조조，량조균진행흉강경수술치료，기중시험조관폐절구전응용간사포잠취안이전도말정개흉강，대조조미응용안이전。비교량조환자적수술시간、술중출혈、술후인류량、술후루기시간，술후발관시간、술후병발증발병솔급술후1년기흉적복발솔。 　　결과여결론：량조수술시간、술중출혈、술후루기시간、술후발제흉관시간급술후병발증적발생솔비교차이균무현저성의의(P >0.05)；시험조술후인류량교대조조명현증가(P <0.05)，단미조성수의학간예적후과；시험조술후1년복발솔저우대조조(P<0.05)。결과표명흉강경수술과정중이용안이전도찰벽층흉막행흉막고정，시일충예방원발성자발성기흉술후기흉복발적가고차유효적치료방식。
BACKGROUND:Some scholars believe that for primary spontaneous pneumothorax thoracoscopic surgery and intraoperative pleurodesis can effectively reduce the recurrence rate. OBJECTIVE:To study the reliability and validity of video-assisted thoracoscopic entoiodine pleurodesis for treatment of primary spontaneous pneumothorax. METHODS:Videothoracoscopy procedures were performed on 64 patients with primary spontaneous pneumothorax, including 46 males and 18 females, with an age ranging from 15 to 30 years. According to the use of pleurodesis, the patients were randomly divided into two groups:experimental group and control group. In the control group, no entoiodine was used;while in the experimental group, entoiodine dipped gauze was used on the visceral pleura. The operation time, intraoperative bleeding, postoperative drainage, postoperative leakage time, postoperative extubation time, postoperative complications and the recurrence rate of pneumothorax within 1 year after operation were compared between two groups. RESULTS AND CONCLUSION:No significance was found in the operation time, intraoperative bleeding, postoperative leakage time, postoperative extubation time and postoperative complications between the two groups (P>0.05). Although the experimental group had significantly more postoperative drainage volume than the control group (P<0.05), there were no consequences of medical intervention. Video-assisted thoracoscopic entoiodine pleurodesis could significantly reduce the recurrence rate of pneumothorax in 1 year after operation (P<0.05). The results show that video-assisted thoracoscopic operation with entoiodine is a reliable and effective method to reduce the recurrence of pneumothorax after operation in patients with primary spontaneous pneumothorax.