中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
18期
12-14
,共3页
机械摩擦胸膜固定%单操作孔电视胸腔镜手术%原发性自发性气胸
機械摩抆胸膜固定%單操作孔電視胸腔鏡手術%原髮性自髮性氣胸
궤계마찰흉막고정%단조작공전시흉강경수술%원발성자발성기흉
Mechanical pleurodesis%Uniportal video assisted thoracoscopic surgery%Primary spontaneous pneumothorax
目的:探讨机械摩擦胸膜固定在单操作孔电视胸腔镜手术( UVATS)治疗原发性自发性气胸( PSP)患者中的可行性和疗效。方法2010年10月至2013年5月,对58例PSP患者行UVATS并且术中给予机械摩擦胸膜固定治疗,同期58例PSP患者行滑石粉胸膜固定。观察手术时间、术中出血量、术后引流量、疼痛程度、白细胞升高水平、带胸管时间及住院时间等临床指标。结果滑石粉组术后体温﹥38.0℃44例(75.8%),显著高于机械摩擦组的10例(17.2%)(χ2=40.052,P=0.0001);滑石粉组术后WBC计数﹥10×109/L 41例(70.6%),显著高于机械摩擦组的9例(15.5%)(χ2=35.995,P=0.0001);滑石粉组胸腔引流量为(655±76)ml,显著多于机械摩擦组的(325±72)ml(t=24.006,P=0.0001);疼痛评分为(1.6±0.7)分,明显低于滑石粉组的(5.3±0.5)分(t=32.756,P=0.0001)。机械摩擦组术后带胸管及住院时间时间明显低于滑石粉组[(24±3.5)h vs(36±7.3)h](t=11.288,P=0.0001)、[(3.0±0.7)d vs(4.8±1.2)d](t=9.867,P=0.0001)。结论机械摩擦胸膜固定在UVATS治疗PSP中明显优于其他胸膜固定术,是安全可行的,能减少手术并发症,且疗效理想。
目的:探討機械摩抆胸膜固定在單操作孔電視胸腔鏡手術( UVATS)治療原髮性自髮性氣胸( PSP)患者中的可行性和療效。方法2010年10月至2013年5月,對58例PSP患者行UVATS併且術中給予機械摩抆胸膜固定治療,同期58例PSP患者行滑石粉胸膜固定。觀察手術時間、術中齣血量、術後引流量、疼痛程度、白細胞升高水平、帶胸管時間及住院時間等臨床指標。結果滑石粉組術後體溫﹥38.0℃44例(75.8%),顯著高于機械摩抆組的10例(17.2%)(χ2=40.052,P=0.0001);滑石粉組術後WBC計數﹥10×109/L 41例(70.6%),顯著高于機械摩抆組的9例(15.5%)(χ2=35.995,P=0.0001);滑石粉組胸腔引流量為(655±76)ml,顯著多于機械摩抆組的(325±72)ml(t=24.006,P=0.0001);疼痛評分為(1.6±0.7)分,明顯低于滑石粉組的(5.3±0.5)分(t=32.756,P=0.0001)。機械摩抆組術後帶胸管及住院時間時間明顯低于滑石粉組[(24±3.5)h vs(36±7.3)h](t=11.288,P=0.0001)、[(3.0±0.7)d vs(4.8±1.2)d](t=9.867,P=0.0001)。結論機械摩抆胸膜固定在UVATS治療PSP中明顯優于其他胸膜固定術,是安全可行的,能減少手術併髮癥,且療效理想。
목적:탐토궤계마찰흉막고정재단조작공전시흉강경수술( UVATS)치료원발성자발성기흉( PSP)환자중적가행성화료효。방법2010년10월지2013년5월,대58례PSP환자행UVATS병차술중급여궤계마찰흉막고정치료,동기58례PSP환자행활석분흉막고정。관찰수술시간、술중출혈량、술후인류량、동통정도、백세포승고수평、대흉관시간급주원시간등림상지표。결과활석분조술후체온﹥38.0℃44례(75.8%),현저고우궤계마찰조적10례(17.2%)(χ2=40.052,P=0.0001);활석분조술후WBC계수﹥10×109/L 41례(70.6%),현저고우궤계마찰조적9례(15.5%)(χ2=35.995,P=0.0001);활석분조흉강인류량위(655±76)ml,현저다우궤계마찰조적(325±72)ml(t=24.006,P=0.0001);동통평분위(1.6±0.7)분,명현저우활석분조적(5.3±0.5)분(t=32.756,P=0.0001)。궤계마찰조술후대흉관급주원시간시간명현저우활석분조[(24±3.5)h vs(36±7.3)h](t=11.288,P=0.0001)、[(3.0±0.7)d vs(4.8±1.2)d](t=9.867,P=0.0001)。결론궤계마찰흉막고정재UVATS치료PSP중명현우우기타흉막고정술,시안전가행적,능감소수술병발증,차료효이상。
Objective To investigate the feasibility and effect of mechanical pleurodesis in the treatment of primary spontaneous pneumothorax( PSP)by uniportal video assisted thoracoscopic surgery(UVATS). Methods From October 2010 to May 2013,58 patients with PSP received UVATS and mechanical pleurodesis during the operation,at the same time,58 patients with PSP re-ceived pleural fixation with talcum powder. The clinical indexes including operation time,blood loss volume during operation,postoperative body temperature,postoperative amount of drainage,pain degree, elevated level of white blood cells,drainage tube duration,hospitalization duration was observed. Re-sults Compared with the talcum powder group,the mechanical pleurodesis group had significantly fewer cases of postoperative fever( ﹥38. 0 ℃)[ 10 cases( 17. 2%)vs 44 cases( 75. 8%),χ2 =40. 052 ,P=0. 0001]and abnormal WBC level( ﹥10 ×109)[9 cases(15. 5%)vs 41 cases(70. 6%),χ2 =35. 995, P=0. 0001],fewer chest drainage volume[(325 ± 72)ml vs(655 ± 76)ml,t=24. 006,P=0. 0001], lower pain score[(1. 6 ± 0. 7)vs(5. 3 ± 0. 5),t=32. 756,P=0. 0001],shorter drainage tube duration [(24 ± 3. 5)h vs(36 ± 7. 3)h,t=11. 288,P =0. 0001]and hospital stays[(3. 0 ± 0. 7)d vs(4. 8 ± 1. 2)d,t=9. 867,P=0. 0001]. Conclusions Mechanical pleurodesis is superior to other pleurodesis in uniportal video assisted thoracoscopic surgery( UVATS)for the treatment of primary spontaneous pneu-mothorax( PSP). It is safe and feasible,also can reduce the complications caused by operation,and the curative effect is ideal.