VATS治疗自发性气胸合并COPD的临床评价

目的：评价电视胸腔镜手术（VATS）治疗慢性阻塞性肺疾病（COPD）并发自发性气胸的效果。方法：回顾分析VATS治疗继发于COPD的自发性气胸79例患者的临床资料,总结其操作要点及部分并发症的处理方法。结果：本组平均手术时间为55.6 min,平均出血量为67.3 ml,术后前3 d胸液引流总量为650～1 700 ml,术后胸管留置平均时间为7.8 d,术后平均住院时间为12.7 d。临床治愈78例（98.73%）,术后肺持续漏气23例（29.11%）,肺部感染42例（53.16%）,死亡1例（1.60%）。术后随访3个月无复发。结论：持续性肺漏气和肺部感染是COPD患者术后常见的并发症,VATS治疗合并COPD的自发性气胸安全有效,适当的运用可以明显改善患者的生存质量。

Efficacy of video-assisted thoracoscopic surgery in treatment of spontaneous pneumothorax companied with chronic obstructive pulmonary disease

Objective： To evaluate the efficacy of Video-assisted thoracoscopic surgery（VATS） in treatment of spontaneous pneumothorax companied with chronic obstructive pulmonary disease（COPD）.Methods： 79 cases of spontaneous pneumothorax companied with COPD treated by VATS were retrospective analysed in order to summarize the operative points and corrective actions to some complications.Results： The mean operation time was 55.6 minutes,the average blood loss was 67.3 ml,the total amount of chest drainage in postoperative three-day was 650 to 1700 ml,chest tube was withdrawn after 7.8 days,the mean postoperative hospital stay was 12.7 dads.78 cases（98.73%）were healed,23 cases（29.11%）had prolonged air-leakage,42 cases（53.16%）had pulmonary infection,and there was 1（1.60%）postoperative death.No recurrence of pneumothorax was found during 3 months after operation.Conclusion：Prolonged air-leakage and pulmonary infection are common complications in COPD patients after operation;VATS is effective for pneumothorax patients with COPD.