急诊电视胸腔镜诊治刀刺伤所致血气胸

目的 探讨急诊应用胸腔镜诊治胸部刀刺伤所致血气胸的手术方法及其优势.方法 分析对21例胸部刀刺伤所致的血气胸行急诊电视胸腔镜探查手术.结果 全组内镜或小切口下缝合肺裂伤23例次,肋间血管出血止血17例次,扩大心包切口并缝合损伤心肌1例次.单纯膈肌损伤修补2例次,合并腹腔脏器损伤经小切口下止血或修补4例次.手术操作时间平均单侧45.6分钟,双侧110.5分钟.本组无手术死亡,无胸部严重并发症发生.术后胸引流管平均拔管时间为2.2天,单纯血气胸术后平均5.8天出院.随访生活质量良好.结论 电视胸腔镜手术是诊断和治疗刀刺伤所致血气胸的一种有效的方法.

Urgent video assisted thoracic surgery (VATS) in the diagnosis and treatment of 21 patients with hemopneumothorax caused by penetrating thoracic knife wound

Objective To evaluate the approach and dominance of video assisted thoracic surgery(VATS) in the diagnosis and treatment of hemopneumothorax caused by penetrating thoracic knife wound in emergency condition.Methods Twenty-one patients with hemopneumothorax caused by penetrating wound of the thorax were performed VATS.Results Twenty-three cases were sutured the lacerated lung wound under endoscope or small incision,17 cases were stopped bleeding of intercostal vessels,1 case was expanded pericardial wound and sutured cardial muscle.Two cases with diaphragmatic injury were repaired,4 cases associated with abdominal organs injury were stopped bleeding and repaired under small incision.The mean operation time of one-side was 45.6 min,two-side was 110.5 min.There was no operation death and thoracic morbidities in this group.The mean length of drainage was 2.2 days.The mean post-operative hospital stay of simple hemopneumothorax patients was 5.8 days.Follow-up showed patients had good quality of life.Conclusion Video assisted thoracic surgery can be utilized as an effective and safe method for the initial diagnostic evaluation and surgical management of patients with hemopneumothorax caused by penetrating thoracic knife wound.