胸腔镜在老年自发性气胸术后复发患者中的治疗价值

目的探讨老年自发性气胸术后复发病例的临床特点和治疗方法。方法回顾性分析35例老年自发性气胸术后复发病例的临床特点及再次手术的治疗方法与临床效果。结果 35例患者均选择胸腔镜下辅助小切口手术治疗,手术时间为80-167（96±38）min,出血量90-210（115±36）ml,无术后围手术期死亡病例。术后保留胸管时间为1-8（4±2）d,术后住院时间为10-l7（11±5）d。成功随访31例,随访时间为1-43个月,随访期内无气胸复发。结论胸腔镜手术可以有效降低气胸复发率。胸部CT薄层扫描是选择手术入路的重要依据。再次手术的指征：有明确肺大疱;有效引流仍持续漏气2周以上;局部纤维板形成影响肺膨胀的局限性气胸;粘连带牵拉限制肺膨胀者。既往手术和胸膜处理等增加胸腔镜手术的难度,但不影响再次手术的效果。

Value of thoracoscope on spontaneous aerothorax recurrence after surgical treatment in elder

Objective To probe the clinical features and therapeutic methods of post-surgery recurrence of spontaneous aerothorax in elder.Methods 35 elder patients with post-surgery recurrence of spontaneous aerothorax were analyzed.Results The treatment with thoracoscope aided by small-incision surgery was performed to all 35 patients.Surgery time was 80～167（96±38）min.The bleeding volume was 90～210（115±36）ml.There was no death in the perioperative period after the surgery.The time for thoracic duct retention after surgery was 1～8（4±2）d,and the hospitalization time after surgery was 10～l7（11±5）d.Conclusion The thoracoscope surgery can effectively minimize the recurrence rate of aerothorax.Previous surgeries and pleura treatment magnify the complexion of the thoracoscope surgery but is not effective for the second surgery.