胸腔镜介入治疗难治性气胸32例的临床观察

目的：探讨内科型胸腔镜治疗难治性气胸的有效方法。方法：运用内科型胸腔镜术，采取以下综合治疗方法：高频电凝术凝固直径小于2cm肺大疱；注射生物胶术治疗直径大于2cm的肺大疱；高频电切术离断胸膜粘连带；滑石粉喷洒术固定胸膜腔。结果：全组32例患者中，I型胸膜病变0例，Ⅱ型胸膜病变3例，均合并有肺大疱；Ⅲ型胸膜病变18例；Ⅳ型胸膜病变11例。治疗后24～72h肺全部复张，肺功能明显改善，随诊6个月～2年，复发率为6．3％，疗效满意。结论：肺大疱并发自发性气胸采用内科型胸腔镜综合治疗，具有安全性佳、疗效好、费用低、患者耐受性好的特点，尤其对肺功能差不能耐受外科手术的患者，是较好的选择。

Abstract：

Objective： To investigate the effective method of treating refractory pneumothorax by thoracoseo py. Methods： Following means were adopted By thoracoscopy： Bullaes diameter less than 2em were coagulated by high frequency electrocoagulation; Bullaes diameter larger than 2cm were injected with biogel; Pleural adhe sions were mutilated by high frequency electrocision; Pleural cavities were fixed with conspergeing Talc Powder. Results： Thirty-two cases were treated by above mentioned methods. The lungs were all stretched open 24-72 hours after treatment, and pulmonary functions were improved obviously. The recurrence rate was 6. 3% after 6 months to two year follow-up and curative effect is satisfactory. Conclusions： The application of thoracoscopy in patients with bullae complicated with spontaneous pneumothorax is safe, effective and low cost, and especially it＇s a better choice for patients with poor pulmonary function who can not tolerate surgery.

Clinical Observation on Thoracoscopy in Treatment of 32 Cases With Refractory Pneumothorax

Objective： To investigate the effective method of treating refractory pneumothorax by thoracoseo py. Methods： Following means were adopted By thoracoscopy： Bullaes diameter less than 2em were coagulated by high frequency electrocoagulation; Bullaes diameter larger than 2cm were injected with biogel; Pleural adhe sions were mutilated by high frequency electrocision; Pleural cavities were fixed with conspergeing Talc Powder. Results： Thirty-two cases were treated by above mentioned methods. The lungs were all stretched open 24-72 hours after treatment, and pulmonary functions were improved obviously. The recurrence rate was 6. 3% after 6 months to two year follow-up and curative effect is satisfactory. Conclusions： The application of thoracoscopy in patients with bullae complicated with spontaneous pneumothorax is safe, effective and low cost, and especially it＇s a better choice for patients with poor pulmonary function who can not tolerate surgery.