中华创伤杂志
中華創傷雜誌
중화창상잡지
Chinese Journal of Traumatology
2014年
3期
260-263
,共4页
蔡庆勇%邢怀华%徐刚%梁贵友%黄德荣%陈慧%王峰
蔡慶勇%邢懷華%徐剛%樑貴友%黃德榮%陳慧%王峰
채경용%형부화%서강%량귀우%황덕영%진혜%왕봉
胸部损伤%麻醉,局部%胸腔镜
胸部損傷%痳醉,跼部%胸腔鏡
흉부손상%마취,국부%흉강경
Thoracic injuries%Anesthesia,local%Thoracoscope
目的 探讨应用局部麻醉电视胸腔镜手术(local anaesthesia video-assisted thoracoscopic surgery,LA-VATS)对开放性胸外伤(open thoracic trauma,OTT)诊治的可行性和优越性.方法 选择2007年2月-2012年6月急诊OTT 78例患者为研究对象,用抛硬币的方法随机分为LA-VATS治疗组(37例)、常规治疗组(41例).LA-VATS治疗组行LA-VATS探查,然后决定下一步治疗方案.常规治疗组按常规方法诊治.对两组胸腔引流量、胸腔管放置时间、住院时间、术后并发症进行对比分析. 结果 LA-VATS治疗组23例LA-VATS完成诊治,14例中转全身麻醉后行单纯VATS辅助小切口剖胸术完成手术治疗.常规治疗组24例完成清创加胸引术,17例在观察治疗一段时间后行全身麻醉剖胸手术治疗.LA-VATS治疗组与常规治疗组术后在胸腔引流量[(195.0±150.8) ml/d∶(480.0±212.3) ml/d](t=-2.675,P＜0.05)、胸腔管放置时间[(2.6±1.4)d∶(3.8±1.9)d](t=-2.318,P＜0.05)、住院时间[(6.4±2.3)d∶(10.9±3.3)d](t=-2.471,P＜0.05)及术后并发症发生率(10.8％∶22.0％) (x2 =4.132,P＜0.05)差异有统计学意义. 结论 LA-VATS对OTT的诊断性探查和简单治疗是安全可行的.
目的 探討應用跼部痳醉電視胸腔鏡手術(local anaesthesia video-assisted thoracoscopic surgery,LA-VATS)對開放性胸外傷(open thoracic trauma,OTT)診治的可行性和優越性.方法 選擇2007年2月-2012年6月急診OTT 78例患者為研究對象,用拋硬幣的方法隨機分為LA-VATS治療組(37例)、常規治療組(41例).LA-VATS治療組行LA-VATS探查,然後決定下一步治療方案.常規治療組按常規方法診治.對兩組胸腔引流量、胸腔管放置時間、住院時間、術後併髮癥進行對比分析. 結果 LA-VATS治療組23例LA-VATS完成診治,14例中轉全身痳醉後行單純VATS輔助小切口剖胸術完成手術治療.常規治療組24例完成清創加胸引術,17例在觀察治療一段時間後行全身痳醉剖胸手術治療.LA-VATS治療組與常規治療組術後在胸腔引流量[(195.0±150.8) ml/d∶(480.0±212.3) ml/d](t=-2.675,P＜0.05)、胸腔管放置時間[(2.6±1.4)d∶(3.8±1.9)d](t=-2.318,P＜0.05)、住院時間[(6.4±2.3)d∶(10.9±3.3)d](t=-2.471,P＜0.05)及術後併髮癥髮生率(10.8％∶22.0％) (x2 =4.132,P＜0.05)差異有統計學意義. 結論 LA-VATS對OTT的診斷性探查和簡單治療是安全可行的.
목적 탐토응용국부마취전시흉강경수술(local anaesthesia video-assisted thoracoscopic surgery,LA-VATS)대개방성흉외상(open thoracic trauma,OTT)진치적가행성화우월성.방법 선택2007년2월-2012년6월급진OTT 78례환자위연구대상,용포경폐적방법수궤분위LA-VATS치료조(37례)、상규치료조(41례).LA-VATS치료조행LA-VATS탐사,연후결정하일보치료방안.상규치료조안상규방법진치.대량조흉강인류량、흉강관방치시간、주원시간、술후병발증진행대비분석. 결과 LA-VATS치료조23례LA-VATS완성진치,14례중전전신마취후행단순VATS보조소절구부흉술완성수술치료.상규치료조24례완성청창가흉인술,17례재관찰치료일단시간후행전신마취부흉수술치료.LA-VATS치료조여상규치료조술후재흉강인류량[(195.0±150.8) ml/d∶(480.0±212.3) ml/d](t=-2.675,P＜0.05)、흉강관방치시간[(2.6±1.4)d∶(3.8±1.9)d](t=-2.318,P＜0.05)、주원시간[(6.4±2.3)d∶(10.9±3.3)d](t=-2.471,P＜0.05)급술후병발증발생솔(10.8％∶22.0％) (x2 =4.132,P＜0.05)차이유통계학의의. 결론 LA-VATS대OTT적진단성탐사화간단치료시안전가행적.
Objective To investigate the feasibility and superiority of local anaesthesia video-assisted thoracoscopic surgery (LA-VATS) in diagnosis and treatment of open thoracic trauma (OTT).Methods Seventy-eight patients with OTT emergently admitted from February 2007 and June 2012 were randomized into LA-VATS group (n =37) and conventional treatment group (n =41) by the toss of a coin.In the LA-VATS group,further treatment was determined following LA-VATS.Volume of chest tube drainage,duration of chest tube placement,average length of hospital stay,and postoperative complications were measured and compared between groups.Results In the LA-VATS group,23 patients completed LA-VATS and 14 were transferred for simple VATS-assisted mini-thoracotomy under general anesthesia.In the conventional treatment group,24 cases completed debridement and chest drainage and 17 cases were transferred for thoracotomy under general anesthesia.Volume of chest tube drainage [(195.0 ± 150.8) ml/d∶ (480.0 ±212.3)ml/d] (t =-2.675,P ＜0.05),duration of chest tube placement [(2.6 ± 1.4) d∶ (3.8 ± 1.9) d] (t =-2.318,P ＜ 0.05),average length of hospital stay [(6.4 ±2.3) d ∶ (10.9 ± 3.3) d] (t =-2.471,P ＜ 0.05),and incidence rate of postoperative complications (10.8％ ∶22.0％) (x2 =4.132,P ＜0.05) were all significantly different between LA-VATS and conventional treatment groups.Conclusion LA-VATS is safe and feasible for diagnostic exploration and simple treatment of OTT.
