中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2013年
6期
643-645
,共3页
气胸%胸腔镜%胸外科手术,电视辅助
氣胸%胸腔鏡%胸外科手術,電視輔助
기흉%흉강경%흉외과수술,전시보조
Pneumothorax%Thoracoscopes%Thoracic Surgery,video-assisted
目的 观察单孔电视胸腔镜(VATS)治疗老年人自发性气胸的临床疗效和安全性,并与传统3孔VATS进行比较. 方法 选取经胸片和CT确诊为自发性气胸患者88例,随机分为单孔VATS组和传统3孔VATS组各44例.记录两组患者术中出血量、手术时间、住院时间、术后镇痛药使用时间、胸管留置时间、术后并发症和不良反应,并随访1～2年,纪录患者气胸复发情况和死亡情况. 结果 单孔VATS组和传统3孔VATS组老年自发性气胸患者均顺利完成胸腔镜手术,术后患者临床症状均消失,胸片示患者气胸消失.单孔VATS组与传统3孔VATS组比较,术中出血量[(46.7±18.8)ml比(61.6±19.2)ml,t=3.04]、镇痛药使用时间[(1.7±0.9)d比(2.4±1.7)d,t=2.18]、住院时间[(6.3±1.7)d比(9.1±2.1)d,t=5.59]差异均有统计学意义(均P＜0.05)；手术时间、胸管留置时间亦均较传统3孔VATS组少.单孔 VATS组患者术后发生胸痛11例,切口麻木7例,显著低于传统3孔VATS组(26例和21例),差异均有统计学意义(t1=10.50、t2=10.26,P＜0.05).两组患者复发率和病死率差异无统计学意义. 结论 单孔 VATS治疗老年人自发性气胸,患者临床恢复情况较好,术后不良反应少,单孔VATS可成为老年人自发性气胸手术治疗的方法之一.
目的 觀察單孔電視胸腔鏡(VATS)治療老年人自髮性氣胸的臨床療效和安全性,併與傳統3孔VATS進行比較. 方法 選取經胸片和CT確診為自髮性氣胸患者88例,隨機分為單孔VATS組和傳統3孔VATS組各44例.記錄兩組患者術中齣血量、手術時間、住院時間、術後鎮痛藥使用時間、胸管留置時間、術後併髮癥和不良反應,併隨訪1～2年,紀錄患者氣胸複髮情況和死亡情況. 結果 單孔VATS組和傳統3孔VATS組老年自髮性氣胸患者均順利完成胸腔鏡手術,術後患者臨床癥狀均消失,胸片示患者氣胸消失.單孔VATS組與傳統3孔VATS組比較,術中齣血量[(46.7±18.8)ml比(61.6±19.2)ml,t=3.04]、鎮痛藥使用時間[(1.7±0.9)d比(2.4±1.7)d,t=2.18]、住院時間[(6.3±1.7)d比(9.1±2.1)d,t=5.59]差異均有統計學意義(均P＜0.05)；手術時間、胸管留置時間亦均較傳統3孔VATS組少.單孔 VATS組患者術後髮生胸痛11例,切口痳木7例,顯著低于傳統3孔VATS組(26例和21例),差異均有統計學意義(t1=10.50、t2=10.26,P＜0.05).兩組患者複髮率和病死率差異無統計學意義. 結論 單孔 VATS治療老年人自髮性氣胸,患者臨床恢複情況較好,術後不良反應少,單孔VATS可成為老年人自髮性氣胸手術治療的方法之一.
목적 관찰단공전시흉강경(VATS)치료노년인자발성기흉적림상료효화안전성,병여전통3공VATS진행비교. 방법 선취경흉편화CT학진위자발성기흉환자88례,수궤분위단공VATS조화전통3공VATS조각44례.기록량조환자술중출혈량、수술시간、주원시간、술후진통약사용시간、흉관류치시간、술후병발증화불량반응,병수방1～2년,기록환자기흉복발정황화사망정황. 결과 단공VATS조화전통3공VATS조노년자발성기흉환자균순리완성흉강경수술,술후환자림상증상균소실,흉편시환자기흉소실.단공VATS조여전통3공VATS조비교,술중출혈량[(46.7±18.8)ml비(61.6±19.2)ml,t=3.04]、진통약사용시간[(1.7±0.9)d비(2.4±1.7)d,t=2.18]、주원시간[(6.3±1.7)d비(9.1±2.1)d,t=5.59]차이균유통계학의의(균P＜0.05)；수술시간、흉관류치시간역균교전통3공VATS조소.단공 VATS조환자술후발생흉통11례,절구마목7례,현저저우전통3공VATS조(26례화21례),차이균유통계학의의(t1=10.50、t2=10.26,P＜0.05).량조환자복발솔화병사솔차이무통계학의의. 결론 단공 VATS치료노년인자발성기흉,환자림상회복정황교호,술후불량반응소,단공VATS가성위노년인자발성기흉수술치료적방법지일.
Objective To compare the clinical efficacy between single span video-assisted thoracoscope (VATS) surgery and traditional VATS surgery for spontaneous pneumothorax in elderly patients.Methods A total of 88 elderly patients diagnosed as spontaneous pneumothorax by chest X-ray and CT were selected and randomly divided into single span VATS group and traditional VATS group (n=44,each).The bleeding volume,duration of operation,hospitalization time,time of postoperative analgesic use,chest tube indwelling time,postoperative complications and adverse reactions were observed.All patients were follow-up for 1-2 years to record the recurrence rate and death rate.Results All patients were received VATS surgery successfully.Their clinical symptoms disappeared and X-ray showed that pneumothorax disappeared.There were significant differences in bleeding volume,time of postoperative analgesic use,hospitalization time between single span VATS group and traditional VATS group [(46.7±18.8)ml vs.(46.7±18.8)ml,(1.7±0.9)d vs.(2.4± 1.7)d,(6.3±1.7)d vs.(9.1±2.1)d,t=3.04,2.18,5.59,respectively,all P＜0.05].The duration of operation and chest tube indwelling were shorter in single span VATS group than in traditional VATS group (both P＜0.05).Patients with chest pain and incision numb after operation were less in single span VATS group than in traditional VATS group (11 cases vs.26 cases,7 cases vs.21 cases,t=10.50,10.26,both P＜0.05).There were no significant differences in recurrence rate and death rate between the two groups.Conclusions Single span VATS surgery is an safe and effective treatment for spontaneous pneumothorax in elderly patients,which has a better postoperative recovery and fewer adverse reactions.
