中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2013年
9期
41-43
,共3页
穿透性胸外伤%急诊%电视胸腔镜手术%胸腔闭式引流术
穿透性胸外傷%急診%電視胸腔鏡手術%胸腔閉式引流術
천투성흉외상%급진%전시흉강경수술%흉강폐식인류술
Penertrating thoracic traumas%Emergency%Video-assisted thoracoscopic surgery%Closed thoracic drainage
目的 探讨应用电视胸腔镜手术(VATS)对穿透性胸外伤(PTT)诊断性探查和简单治疗的可行性和优越性.方法 以2005年2月至2011年1月期间因刀刺伤急诊住院的PTT患者作为研究对象.VATS:患者入院后行VATS探查处理,共21例；常规组:按常规方法诊疗的PTT患者,共25例.对两组患者的观察指标即胸腔引流管(胸管)引流量、胸管放置时间、平均住院时间、术后并发症及住院费用等进行对比分析.结果 两组临床资料比较差异无统计学意义(P＞0.05),VATS组全部患者顺利完成PTT病情探查后,13例VATS完成简单治疗,8例VS-TA或开胸术完成手术治疗.常规组16例完成胸膜腔闭式引流术观察和治疗,9例在观察治疗一段时间后采取全麻手术治疗.两组比较,VATS组明显优于常规组,具有胸管放置时间短、日引流量少、平均住院时间短、术后并发症低等优点.结论 VATS对PTT的病情能做出明确的判断,为下一步治疗提供依据,其诊疗方法比常规治疗法有许多优越性,是安全可行的.
目的 探討應用電視胸腔鏡手術(VATS)對穿透性胸外傷(PTT)診斷性探查和簡單治療的可行性和優越性.方法 以2005年2月至2011年1月期間因刀刺傷急診住院的PTT患者作為研究對象.VATS:患者入院後行VATS探查處理,共21例；常規組:按常規方法診療的PTT患者,共25例.對兩組患者的觀察指標即胸腔引流管(胸管)引流量、胸管放置時間、平均住院時間、術後併髮癥及住院費用等進行對比分析.結果 兩組臨床資料比較差異無統計學意義(P＞0.05),VATS組全部患者順利完成PTT病情探查後,13例VATS完成簡單治療,8例VS-TA或開胸術完成手術治療.常規組16例完成胸膜腔閉式引流術觀察和治療,9例在觀察治療一段時間後採取全痳手術治療.兩組比較,VATS組明顯優于常規組,具有胸管放置時間短、日引流量少、平均住院時間短、術後併髮癥低等優點.結論 VATS對PTT的病情能做齣明確的判斷,為下一步治療提供依據,其診療方法比常規治療法有許多優越性,是安全可行的.
목적 탐토응용전시흉강경수술(VATS)대천투성흉외상(PTT)진단성탐사화간단치료적가행성화우월성.방법 이2005년2월지2011년1월기간인도자상급진주원적PTT환자작위연구대상.VATS:환자입원후행VATS탐사처리,공21례；상규조:안상규방법진료적PTT환자,공25례.대량조환자적관찰지표즉흉강인류관(흉관)인류량、흉관방치시간、평균주원시간、술후병발증급주원비용등진행대비분석.결과 량조림상자료비교차이무통계학의의(P＞0.05),VATS조전부환자순리완성PTT병정탐사후,13례VATS완성간단치료,8례VS-TA혹개흉술완성수술치료.상규조16례완성흉막강폐식인류술관찰화치료,9례재관찰치료일단시간후채취전마수술치료.량조비교,VATS조명현우우상규조,구유흉관방치시간단、일인류량소、평균주원시간단、술후병발증저등우점.결론 VATS대PTT적병정능주출명학적판단,위하일보치료제공의거,기진료방법비상규치요법유허다우월성,시안전가행적.
Objective To study the feasibility and superiority of video-assisted thoracoscopic surgery (VATS) in the exploring diagnosis and simple treatment of penertrating thoracic traumas (PTT) under local anesthesia.Methods From February 2005 to January 2011,patients admitted in emergency hospitalization due to the PTT caused by stab were chosed.The VATS treatment group:Videoassisted thoracoscopic surgery was used in 21 patients,under local anesthesia for the explorating chest injury situation,then decide the next step treatment programmes.Conventional treatment group:25 patients who treated by conventional methods were chosed,observed indicators including transfusing volume,duration of postoperative chest drainage,average length of hospitalization,complication rate,and hospitalization expenses.Results There was no significant difference in the two groups.VATS explorating were successfully completied in the study group.Thirteen patients accepted the simple treatment,8 patients accepted thoracoscopy-assisted mini-incision surgery or conversion to open surgery.In the conventional treatment group,16 patiens received observation and treatment after closed drainage.Then 9 patients of them were operated under general anesthesia.The study group was clearly superior to the compared group.Such as the study group has short hospitalization time,less liquid drainage,low complications,there was no significant difference in hospitalization expenses between the two groups.Conclusions VATS can make a correct judgement in PTT injury situation and provide evidence for further treatment.Thoracoscopic detection method is clearly superior to conventional treatment method in PTT.And it is safe and feasible in exploring diagnosis and it simple treatment of VATS in PTT.
