CAJ | 학술논문

目的：比较单操作孔胸腔镜（video－assisted thoracoscopic surgery，VATS）与传统三孔胸腔镜手术治疗自发性气胸的临床效果。方法选取2011年5月至2014年5月于我院肺大疱自发性气胸手术病人，分为单孔VATS组30例和传统三孔VATS组31例，观察病人手术时间、术中出血量、术后胸腔闭式引流管放置时间、住院时间、术后对切口的满意度、并发症的发生情况，记录术后6 h和24 h的疼痛评分。结果单孔VATS组的手术时间（131.37±14.15 min）长于传统三孔胸腔镜组（114.21±11.11 min）（P＝0.03），术后6 h疼痛评分（3.31±1.47）低于传统VATS组（4.69±1.38）（P＝0.01），术后病人对切口的满意度评分（4.76±2.13）高于传统VATS组（2.60±1.76）（P＝0.02），术中出血量、胸腔闭式引流管引流量及放置时间、术后24 h疼痛评分、住院时间，以及并发症的发生率等比较差异均无统计学意义（P＞0.05）。结论单操作孔胸腔镜手术治疗肺大疱自发性气胸可减轻术后疼痛，美容效果好，且并不增加手术风险。可以作为肺大疱自发性气胸病人首选术式。
목적：비교단조작공흉강경（video－assisted thoracoscopic surgery，VATS）여전통삼공흉강경수술치료자발성기흉적림상효과。방법선취2011년5월지2014년5월우아원폐대포자발성기흉수술병인，분위단공VATS조30례화전통삼공VATS조31례，관찰병인수술시간、술중출혈량、술후흉강폐식인류관방치시간、주원시간、술후대절구적만의도、병발증적발생정황，기록술후6 h화24 h적동통평분。결과단공VATS조적수술시간（131.37±14.15 min）장우전통삼공흉강경조（114.21±11.11 min）（P＝0.03），술후6 h동통평분（3.31±1.47）저우전통VATS조（4.69±1.38）（P＝0.01），술후병인대절구적만의도평분（4.76±2.13）고우전통VATS조（2.60±1.76）（P＝0.02），술중출혈량、흉강폐식인류관인류량급방치시간、술후24 h동통평분、주원시간，이급병발증적발생솔등비교차이균무통계학의의（P＞0.05）。결론단조작공흉강경수술치료폐대포자발성기흉가감경술후동통，미용효과호，차병불증가수술풍험。가이작위폐대포자발성기흉병인수선술식。
Objective To compare the clinical effect of surgical treatment of spontaneous pneumothorax be-tween uniportal and conventional video-assisted thoracoscopic surgery (VATS).Methods 61 patients with sponta-neous pneumothorax were selected in our hospital from May 201 1 to May 201 4,and they were divided into the unipor-tal VATS group (30 cases)and the conventional VATS group (31 cases).Their operation time,intraoperative blood loss,closed chest drainage tube replacement time after operation,duration of hospital stay,satisfaction and complica-tions were observed.The score of pain was recorded 6 and 24 hours after the operation.Results The operation time was (1 31 .37 ±1 4.1 5 min)in the uniportal VATS group,which was longer than that in the conventional VATS group (114.21 ±11.11min)(P=0.03).The score of pain 6h after the operation was (3.31 ±1.47)in the uniportal VATS group,which was lower than that in the conventional VATS group (4.69 ±1.38)(P=0.01 ).The satisfac-tion score of postoperative incision was (4.76 ±2.1 3 )in the uniportal VATS group,which was higher than that of the conventional VATS group (2.60 ±1.76)(P=0.02).There was no significant difference in blood loss,postop-erative drainage volume of closed thoracic drainage tube and duration,pain score 24h after the operation,duration of hospital stay and complications between the two groups (P>0.05 ).Conclusion The uniportal VATS can reduce postoperative pain and get good cosmetic effect in the treatment of patients with spontaneous pneumothorax.