急诊胸腔镜在自发性血气胸诊治中的应用

目的探讨急诊胸腔镜手术（video—assisted thoracoscopic surgery，VATS）在自发性血气胸诊治中的应用价值。方法2008年1月-2013年6月，急诊VATS治疗自发性血气胸37例，术中电凝或钛夹止血，同期切除肺大疱。结果全组手术顺利，无中转开胸，手术时间50～110min，平均70min。术后胸管留置时间1—5d，平均2．8d，住院时间3—9d，平均5．4d。全组治愈出院，无严重并发症及围术期死亡。32例随访12～24个月，平均17个月，无气胸或血气胸复发。结论急诊VATS治疗自发性血气胸安全有效，创伤小，恢复快，住院时间短，值得临床推广。

Application of Video-assisted Thoracoscopic Surgery in the Treatment of Spontaneous Hemopneumothorax in Emergency

Objective To investigate clinical application of video-assisted thoracoscopic surgery （VATS） in the treatment of spontaneous hemopneumothorax in emergency. Methods From January 2008 to June 2013, 37 cases of spontaneous hemopneumothorax underwent urgent application of VATS. During the operation, the bleeding was stopped by eleetrocoagulation or titanium clipping. The pulmonary bulla was resected during the operation. Results The operations were completed successfully in all the 37 cases, without conversion to open surgery. The average operation time was 70 rain （range, 50 - 110 min）. The average chest tube indwelling time was 2.8 days （ range, 1 - 5 days）. The average hospitalization length was 5.4 days （ range, 3 - 9 days）. All the patients were recovered and discharged from hospital, without serious complications or death. A follow-up examination for 12 - 24 months （mean, 17 months） was carried out in 32 cases, during which no recurancc was seen. Conclusions Urgent use of VATS in the treatment of spontaneous pneumothorax is safe and effective. It has advantages of minimal invasion, rapid recovery, and short hospital stay, being worthy of clinical application.