CAJ | 학술논문

目的：开胸手术与胸腔镜手术治疗自发性气胸的效果比较。方法选自2009年10月-2014年12月该院收治的自发性气胸进行手术的患者作为研究对象，共收集105例，分别为开胸组(n=60)和胸腔镜组(n=45)这两组。对两组患者均使用静脉吸入复合麻醉，并让患者呈90o侧卧位。对开胸组患者使用开胸手术，对胸腔镜组患者采用胸腔镜手术。结果相比于开胸组，胸腔镜组患者在手术时间、术中出血量、切口长度、引流管留置时间和住院天数方面的指标均明显要低，差异有统计学意义(P<0.05)；开胸组的60例患者并发症的发生率为36.67%；胸腔镜组的45例患者并发症的发生率为8.89%。胸腔镜组的治疗效果明显高于开胸组(P<0.05)；开胸组患者的病情复发率为3.33%，胸腔镜组患者的病情复发率为2.22%，两组比较差异无统计学意义(P>0.05)。结论和开胸手术相比较，胸腔镜手术治疗自发性气胸，患者出血少、恢复快、手术时间短、术后并发症和复发率低，值得医师和患者优先选择，但手术材料费用偏高。
목적：개흉수술여흉강경수술치료자발성기흉적효과비교。방법선자2009년10월-2014년12월해원수치적자발성기흉진행수술적환자작위연구대상，공수집105례，분별위개흉조(n=60)화흉강경조(n=45)저량조。대량조환자균사용정맥흡입복합마취，병양환자정90o측와위。대개흉조환자사용개흉수술，대흉강경조환자채용흉강경수술。결과상비우개흉조，흉강경조환자재수술시간、술중출혈량、절구장도、인류관류치시간화주원천수방면적지표균명현요저，차이유통계학의의(P<0.05)；개흉조적60례환자병발증적발생솔위36.67%；흉강경조적45례환자병발증적발생솔위8.89%。흉강경조적치료효과명현고우개흉조(P<0.05)；개흉조환자적병정복발솔위3.33%，흉강경조환자적병정복발솔위2.22%，량조비교차이무통계학의의(P>0.05)。결론화개흉수술상비교，흉강경수술치료자발성기흉，환자출혈소、회복쾌、수술시간단、술후병발증화복발솔저，치득의사화환자우선선택，단수술재료비용편고。
Objective To compare the open chest operation with video-assisted thoracoscopic operation effect of treatment of spontaneous pneumothorax. Methods From October 2009 to December 2014,a total of 105 patients with spontaneous pneumotho-rax in our hospital were selected as the research object, and divided into two groups, respectively thoracotomy group (n=60) and video-assisted thoracoscopic group (n=45). On two groups of patients using intravenous inhalation anesthesia, and let the patient taking 90 degree lateral position. The thoracotomy group patients using surgical thoracotomy, VATS group of patients using video-assisted thoracoscopic surgery. Results Compared to thoracotomy group, the VATS group patients in the operation time, amount of bleeding during the operation, incision length, drainage tube indwelling time and hospital stay were significantly lower in terms of indicators, with significant difference (P<0.05);60 cases of complications in patients with thoracotomy group the incidence rate was 36.67%; 45 patients complications of thoracoscopic group occurred in 8.89%. The therapeutic effect of thoracoscopic group was significantly higher than that of thoracotomy group (P<0.05); thoracotomy group patients relapse rate was 3.33%and the VATS pa-tients relapse rate was 2.22%, two groups had no statistically significance (P>0.05). Conclusion Compared with the open chest op-eration, thoracoscopic operation treatment of spontaneous pneumothorax with less bleeding, quick recovery, short operation time, postoperative complications and low recurrence rate, is worth to physician and patient preference, but the operation material cost is high.