单孔胸腔镜手术与传统胸腔镜手术治疗自发性气胸疗效的对比研究

目的 比较单孔胸腔镜手术（single-port video-assisted thoracoscopic surgery,SPVATS）与传统胸腔镜手术（video-assisted thoracoscopic surgery,VATS）治疗自发性气胸的疗效.方法 采集2009年1月至2013年1月收治自发性气胸200例,比较分析SPVATS组（n=99）和VATS组（n=101）的手术时间、术中出血量、胸管引流时间、术后住院时间、术后漏气（术后持续漏气＞7d）、术后疼痛、远期复发、手术费用和住院总费用等临床指标.结果 所有病例手术顺利,无中转开胸,无死亡及严重并发症发生.SPVATS组比VATS组手术时间短,术中出血量少,术后24h、72h疼痛小（P＜0.05）.两组患者术后1周疼痛、胸管引流时间、术后住院时间、手术费用、术后漏气、远期复发气胸例数的差异均无统计学意义（P＞0.05）.结论 SPVATS治疗自发性气胸与VATS手术相比较同样安全有效,且创伤及术后疼痛程度更轻,近期疗效满意,值得进一步临床推广.

Contrast Research between Single-port Video-assisted Thoracoscopic Surgery and Traditional Thoracoscope Surgery for the Treatment of Spontaneous Pneumothorax

Objective To compare the curative effect of the single - port video - assisted thoracoscopic surgery（SPVATS） and traditional video -assisted thoracoscopic surgery（VATS） in patients with spontaneous pneumothorax. Methods 200 cases with spontaneous pneumothorax were recruited in research between January 2009 and January 2013. Operative time, intraoperative blood loss, postoperative hospital stay, postoperative chest tube drainage time leak （ leak 〉 7 days）, postoperative pain, long - term recurrence, operation cost and the total cost of hospitalization were compared between SPVATS and VATS group. Results All operations got success with no thoracotomy and no death and serious complications occurred. Patients in SPVATS group had significantly shorter operation tim, less intraoperative blood loss, lighter postoperative pain than patients in control group VATS had （P 〈 0.01 ）. Chest tube drainage time, postoperative length of hospital stay, surgery postoperative leakage, and the forward recurrent pneumothorax showed no significant difference between two groups. Conclusion SPVATS has the same safety and effectiveness in treatment of spontaneous pneumothorax as VATS has. SPVATS has lighter trauma and postoperative pain than VATS has and it is worth further clinical promotion.