经剑突下入路单孔胸腔镜手术治疗肺大疱的临床效果

目的探讨经剑突下入路单孔胸腔镜手术治疗肺大疱的临床效果。方法选取我院收治的52例自发性气胸合并肺大疱患者进行回顾性分析。根据手术入路方式的不同将其分为观察组(n=24,经剑突下入路胸腔镜肺大泡切除术)和对照组(n=28,经胸入路单孔胸腔镜肺大泡切除术)。比较两组术后1、2、3 d的VAS评分、住院时间、住院总费用、手术相关指标及并发症发生情况。结果两组患者均顺利出院,无围手术期死亡患者。观察组术后1、2、3 d的VAS评分均低于对照组,住院时间短于对照组,住院总费用少于对照组(P<0.05)。两组的单侧肺大疱手术时间、术中出血量、术后胸腔引流管拔除时间、引流量及术后并发症总发生率无显著差异(P>0.05);观察组双侧肺大疱患者的手术时间短于对照组(P<0.05)。结论经剑突下入路胸腔镜手术治疗肺大疱可较经胸入路单孔胸腔镜促进患者术后恢复,可作为肺大疱的一种安全、有效的治疗方法,值得在临床推广。

Clinical effect of single-port thoracoscopic surgery via subxiphoid approach in the treatment of pulmonary bullae

Objective To investigate the clinical effect of single-port thoracoscopic surgery via subxiphoid approach in the treatment of pulmonary bullae.Methods A retrospective analysis was conducted on 52 patients with spontaneous pneumothorax complicated with pulmonary bullae admitted in our hospital.According to the different surgical approach methods,the patients were divided into observation group(n=24,thoracoscopic bullae resection via subxiphoid approach)and control group(n=28,single-port thoracoscopic bullae resection via thoracic approach).The VAS scores at 1,2 and 3 d after surgery,hospitalization time,total hospitalization expenses,surgically related indexes and complications were compared between the two groups.Results The patients in both group discharged smoothly.There were no perioperative deaths patients.The VAS scores at 1,2 and 3 d after surgery of the observation group were lower than those of the control group,the hospitalization time was shorter than that of the control group,and the total hospitalization cost was less than that of the control group(P<0.05).There were no significant differences in the operation time,intraoperative blood loss,postoperative removal time of thoracic drainage tube,drainage volume and the total incidence of postoperative complications of patients with unilateral pulmonary bullae between the two groups(P>0.05);the operation time of patients with bilateral pulmonary bullae in the observation group was shorter than that in the control group(P<0.05).Conclusion Thoracoscopic surgery via subxiphoid approach in the treatment of pulmonary bullae can promote the postoperative recovery of patients compared with single-hole thoracoscopic surgery via transthoracic approach.It can be used as a safe and effective method for the treatment of pulmonary bullae,and which is worth popularizing in clinic.