CAJ | 학술논문

目的：评价单操作孔胸腔镜手术在肺大疱治疗中的临床疗效和安全性。方法总结分析单操作孔胸腔镜下手术治疗的38例肺大疱患者资料。结果30例患者在全身麻醉＋双腔气管插管麻醉下，8例患者在全身麻醉＋单腔气管插管＋气管封堵器麻醉下，均采用单操作孔胸腔镜下手术切除肺大疱，其中2例患者同期行双侧肺大疱切除术。36例获得成功，1例单侧肺大疱术后因进行性血胸伴大量气胸再次开胸探查；1例单侧肺大疱术后因呼吸衰竭，呼吸机辅助呼吸2 d后好转。平均手术时间52 min。胸腔闭式引流管拔除平均时间3．2 d。术后住院时间6 d。术后随访7～39个月，无复发及其他并发症。无死亡病例。结论单操作孔胸腔镜下手术治疗肺大疱安全可靠，符合微创外科理念，值得推广。
목적：평개단조작공흉강경수술재폐대포치료중적림상료효화안전성。방법총결분석단조작공흉강경하수술치료적38례폐대포환자자료。결과30례환자재전신마취＋쌍강기관삽관마취하，8례환자재전신마취＋단강기관삽관＋기관봉도기마취하，균채용단조작공흉강경하수술절제폐대포，기중2례환자동기행쌍측폐대포절제술。36례획득성공，1례단측폐대포술후인진행성혈흉반대량기흉재차개흉탐사；1례단측폐대포술후인호흡쇠갈，호흡궤보조호흡2 d후호전。평균수술시간52 min。흉강폐식인류관발제평균시간3．2 d。술후주원시간6 d。술후수방7～39개월，무복발급기타병발증。무사망병례。결론단조작공흉강경하수술치료폐대포안전가고，부합미창외과이념，치득추엄。
Objective To assess the clinical efficacy and safety of uniport video-assisted thoracoscopic surgery in treatment of pulmonary bulla.Methods Clinical data of 38 patients with pulmonary bulla treated with uniport video-assisted thoracoscopic surgery were analyzed.Results 30 patients under general anesthesia and double-chamber tracheal intubation anesthesia and 8 patients under general anesthesia and single-chamber tracheal intubation and tracheal plugger anesthesia underwent the resection of their pulmonary bulla through the surgery with uniport video-assisted thoracoscope, and 2 patients therein were simultaneously treated with bilateral resection of pulmonary bulla.36 patients were treated successfully;1 patient was given another exploratory thoracotomy after his unilateral surgery because of progressive hemothorax and substantial pneumothorax;and 1 patient underwent respiratory failure after his unilateral surgery and was improved in respiration 2 days after the help of a respirator.The average time of operations were 52 minutes.It averagely took 3.2 days to remove closed thoracic drainage pipes.The post-operation hospital stays took 6 days.The post-operation follow-up took 7-39 months,without relapse and other compli-cations.No death occurred in this group.Conclusion It is safe and reliable to treat pulmonary bulla by the surgery with uniport video-assisted thoracoscope,which is in line with the concept of minimally invasive surgery and therefore deserves promotion.