皖南医学院学报
皖南醫學院學報
환남의학원학보
ACTA ACADEMIAE MEDICINAE WANNAN
2013年
5期
365-367
,共3页
复发性气胸%胸腔镜辅助小切口%电视胸膜腔术%标准后外侧切口术%评价指标
複髮性氣胸%胸腔鏡輔助小切口%電視胸膜腔術%標準後外側切口術%評價指標
복발성기흉%흉강경보조소절구%전시흉막강술%표준후외측절구술%평개지표
recurrent pneumothorax%video-assisted minithoracotomy ( VAMT)%TV pleural cavity surgery%standard posterolateral incision sur-gery%evaluation index
目的：探讨3种不同术式治疗复发性气胸的临床疗效。方法：146例患者根据手术方式不同分为胸腔镜辅助小切口组42例、完全胸腔镜组67例及常规开胸组37例。疗效观察及评价指标为：平均年龄，手术时间，术中出血量，术后引流量，术后疼痛天数，恢复正常活动时间，住院费用。结果：手术时间，术中出血量，术后引流量，术后疼痛天数，术后住院时间，恢复正常活动时间，胸腔镜辅助小切口组与完全胸腔镜组比较无显著差异，但前者住院费用明显低于胸腔镜组（P＜0．01）。常规开胸切口出血多，术后疼痛明显，恢复慢，治疗费用介于两者之间。结论：3种手术方式均安全有效，术后并发症少。胸腔镜辅助小切口毕竟有切口存在，未能达到真正的微创，年轻患者不愿接受。电视胸膜腔术治疗除费用相对较高外，其他优势明显，易被患者接受，必将成为常规开展术式。标准后外侧切口术现已基本不用。
目的：探討3種不同術式治療複髮性氣胸的臨床療效。方法：146例患者根據手術方式不同分為胸腔鏡輔助小切口組42例、完全胸腔鏡組67例及常規開胸組37例。療效觀察及評價指標為：平均年齡，手術時間，術中齣血量，術後引流量，術後疼痛天數，恢複正常活動時間，住院費用。結果：手術時間，術中齣血量，術後引流量，術後疼痛天數，術後住院時間，恢複正常活動時間，胸腔鏡輔助小切口組與完全胸腔鏡組比較無顯著差異，但前者住院費用明顯低于胸腔鏡組（P＜0．01）。常規開胸切口齣血多，術後疼痛明顯，恢複慢，治療費用介于兩者之間。結論：3種手術方式均安全有效，術後併髮癥少。胸腔鏡輔助小切口畢竟有切口存在，未能達到真正的微創，年輕患者不願接受。電視胸膜腔術治療除費用相對較高外，其他優勢明顯，易被患者接受，必將成為常規開展術式。標準後外側切口術現已基本不用。
목적：탐토3충불동술식치료복발성기흉적림상료효。방법：146례환자근거수술방식불동분위흉강경보조소절구조42례、완전흉강경조67례급상규개흉조37례。료효관찰급평개지표위：평균년령，수술시간，술중출혈량，술후인류량，술후동통천수，회복정상활동시간，주원비용。결과：수술시간，술중출혈량，술후인류량，술후동통천수，술후주원시간，회복정상활동시간，흉강경보조소절구조여완전흉강경조비교무현저차이，단전자주원비용명현저우흉강경조（P＜0．01）。상규개흉절구출혈다，술후동통명현，회복만，치료비용개우량자지간。결론：3충수술방식균안전유효，술후병발증소。흉강경보조소절구필경유절구존재，미능체도진정적미창，년경환자불원접수。전시흉막강술치료제비용상대교고외，기타우세명현，역피환자접수，필장성위상규개전술식。표준후외측절구술현이기본불용。
Objective:To assess the treatment effects on recurrent pneu-mothorax with three different surgical intervention .Methods:146 patients with recurrent pneumothorax were randomly allocated to group of video-as-sisted mini-thoracotomy ( VAMT, n =42 ) , video-assisted thoracoscopic surgery(VATS,n=67)and conventional thoracotomy(n=37)on diverse surgery basis.The curative effects were observed and related indicators were assessed regarding the mean ages, surgical duration, intraoperative blood loss, drainage quantity after operation , days of postoperative pain and normal activity recovery, hospital stay and hospital costs.Results:VAMT and VATS groups remained similarly concerning the surgical dura-tion, intraoperative bleeding, drainage quantity after operation, days of postoperative pain,hospital stay and recovery of normal activities after sur-gery,yet the former required lower hospital costs than the latter ( P <0.01).Conventional thoracotomy had much intraoperative blood loss,se-verer postoperative pain and slower recovery,and its medical cost was in the middle of the previous two.Conclusion:Although the three surgical interventions are effective for recurrent pneumothorax ,with fewer postoper-ative complications,yet VAMT leads to failure of minimal invasion and less acceptability in younger patients for its incision imprint .VATS is more acceptable and superior to the other two except for relatively high medical costs,which shall be widely used in clinic.Conventional thoracot-omy tends to be behind the times for its disadvantages .
