胸腔镜治疗老年自发性气胸的临床疗效观察

目的 比较腋下小切口、胸腔镜下手术及常规手术方法治疗老年自发性气胸的临床疗效.方法 65例老年自发性气胸患者分别采用腋下小切口手术（A组）,常规手术（B组）,和胸腔镜下手术（C组）,评价疗效指标.结果 除了腋下小切口组在手术时间较常规手术组明显延长（P〈0.01）以外,胸腔镜组和腋下小切口组在胸管留置时间、术中出血、住院时间、手术时间和术后疼痛评分及术后2周肺功能变化均较常规手术组明显减少或改善（P〈0.01）;而胸腔镜组与腋下小切口组比较均有统计学意义（P〈0.01）.结论 在治疗老年自发性气胸中,胸腔镜手术和腋下小切口治疗更优于常规手术治疗,腋下小切口治疗老年自发性气胸疗效确切,费用较低;胸腔镜治疗老年自发性气胸创伤小.

Observation of clinical effect of thoracoscopic surgery in the treatment of elderly patients with spontaneous pneumothorax

Objective To compare the effect of mini-thoractomy, thoracoscopic surgery and general surgery in the treatment of elderly patients with spontaneous pneumothorax. Methods 65 elderly patients with spontaneous pneumothorax were randomly divided into three groups ： the mini-thoractomy group （ n = 23 ）, the general surgery group （ n = 20 ）, and the thoracoscopic surgery group （ n = 22 ）. The evaluation of clinical efficacy indexes included surgery duration, pain score, postoperative duration of hospital stay, blood loss, chest tube time and changes in lung function. Results The surgery duration was obviously longer in the mini-thoractomy group than in the gen- eral surgery group, and the improvement of pain score, postoperative duration of hospital stay, blood loss, chest tube time and lung func- tion was more pronounced in the mini-thoractomy group and the thoracoscopic surgery group than in the general surgery group （ P 〈0.01 ）. Conclusion Thoracoscopic surgery and mini-thoractomy are better than general surgery in the treatment of elderly patients with spontane- ous pneumothorax, but they cost higher. Mini-tboractomy is effective and economical, while thoracoscopic surgery is minimally invasive.