临床外科杂志 ›› 2021, Vol. 29 ›› Issue (6): 530-533.doi: 10.3969/j.issn.1005-6483.2021.06.010

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剑突下与肋间单孔电视辅助胸腔镜手术治疗双侧肺大泡的疗效分析

  

  1. 西部战区空军医院胸心外科
  • 出版日期:2021-06-20 发布日期:2020-06-20

Comparison of the efficacy and safety of subxiphoid and intercostal videoassisted thoracoscopy for bilateral bullae resection

  • Online:2021-06-20 Published:2020-06-20

摘要: 目的:比较剑突下单孔电视辅助胸腔镜和肋间单孔电视辅助胸腔镜两种手术方法切除双侧肺大泡的临床效果及安全性。方法:2014年9月~2019年9月我院胸心外科收治的双侧肺大泡病人320例,随机数表法分为剑突下组和肋间组,每组各160例;剑突下组给予剑突下单孔电视辅助胸腔镜手术方式,肋间组给予肋间单孔电视辅助胸腔镜手术方式,随访3个月,观察两组病人手术、住院及并发症情况。结果:剑突下组病人术中出血量及总出血量、手术时间、保留引流管时间、住院时间均少于肋间组,两组比较差异有统计学意义(P<0.05)。剑突下组病人术后即刻、2小时、12小时及24小时VAS评分和舒适度评分均低于肋间组,两组比较差异有统计学意义(P<0.05)。两组均无因胸腔镜手术发生引起死亡的病例,剑突下组并发症发生率低于肋间组,差异有统计学意义(P<0.05)。结论:剑突下单孔电视辅助胸腔镜手术治疗双侧肺大泡较传统肋间单孔电视辅助胸腔镜具有出血量少、疼痛减轻、增加舒适度及减少并发症发生率的优势。

关键词: 肺大泡, 双侧, 胸腔镜, 疼痛视觉模拟评分

Abstract: Objective:To compare the clinical effect and safety of subxiphoid singlepore videoassisted thoracoscopy and intercostal singlepore videoassisted thoracoscopy in the treatment of bilateral bullae.Methods:320 patients with bilateral pulmonary bulbar admitted to the department of thoracic and cardiac surgery of the air force hospital of the western theater command from September 2014 to September 2019 were selected.All cases were divided into subxiphoid group and intercostal group according to the random number table,160 cases each.In the subxiphoid group,videoassisted thoracoscopy was performed with single hole of subxiphoid.The intercostal group was treated with videoassisted thoracoscopic surgery with single intercostal foramina,followed up for 3 months,and the operation,hospitalization and complications of the patients in the two groups were observed.Results:There was significant difference in the intraoperative blood loss,total blood loss,operation time,drainage tube retention time and hospitalization time of the patients between the subxiphid process group and the intercostal group(P<0.05).The VAS score and comfort score of patients in the subxiphoid group were significantly better than those in the intercostal group,and the difference was statistically significant(P<0.05).There were no death complications caused by thoracoscopic surgery in the two groups,and the incidence of complications in the subxiphoid group was significantly lower than that in the intercostal group,with a statistically significant difference(P<0.05).Conclusion:Compared with traditional intercostal singlehole videoassisted thoracoscopy,single hole videoassisted thoracoscopy under xiphoid has the advantages of less bleeding,less pain,more comfort and less complication rate,which is safe and reliable and worthy of clinical promotion and application.

Key words: pulmonary bullae, on both sides, thoracoscope, visual analogue score for pain

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