高海拔地区电视胸腔镜手术与常规开胸手术治疗胸部疾病的临床对照研究

目的：探讨高海拔地区（海拔1517m）电视胸腔镜手术（VATS）与开胸手术治疗胸部疾病的效果。方法：回顾性分析我院916例VATS和836例开胸手术切口长度、手术时间、引流时间、术中出血量、住院时间、术后并发症、术后止痛药用量、肺癌患者淋巴结清扫效果、术后生存率。结果：VATS切口长度（4．6±1．7）cm、手术时间（85．5±35．7）min、引流时间（2．3±1．3）min、术中出血量（130．6±64．6）ml、术后并发症（7／916）、术后止痛药用量（175．5±25．5）mg均优于开胸手术，有显著性差异（P〈0．05）。结论：高海拔地区（≥1500m）VATS明显优于开胸手术，老年、高龄患者胸部疾病治疗应首选VATS。

Comparison of video-assisted thoracoscopic surgery with conventional thoracotomy in the treatment of thoracic diseases in high altitude

Objective： To investigate the efficacy of video- assisted thoracoscopic surgery （VATS） and conventional thoracotomy in the treatment of thoracic diseases in high altitude. Methods： The incision length, duration of operation, duration of chest drainage, intraoperative blood loss, hospital stay, postoperative complication, dosage of analgesic, rate of lymph node clearance and survival rate were retrospectively analyzed in 916 patients treated by VATS and 836 patients treated by conventional thoracotomy. Results： The incision length, duration of chest drainage, intraoperative blood loss, postoperative complication （ pulmonary infection） and dosage of analgesic in VATS group were superior to those in conventional thoracotomy group, and there were significant differences in these data between the two groups （ P 〈 0.05 ）. Conclusion： The therapeutic efficacy of VATS is better than that of conventional thoracotomy in the treatment of thoracic diseases in high altitude, especially for the elderly patients.