电视胸腔镜(VATS)和传统开胸手术治疗急性脓胸的疗效比较

目的对比电视胸腔镜（VATS）和传统开胸手术治疗急性脓胸的疗效。方法分别应用VATS对82例急性脓胸患者及传统手术对75例急性脓胸患者行脓胸病灶清除、纤维板剥脱术,使被压缩的肺组织充分膨胀,观察两种手术效果及并发症情况。结果以上两种方法均无手术及麻醉并发症,无死亡病例。VATS与开胸手术比较,手术时间缩短（51.38±14.38）minvs.（106.07±46.19）min],术中出血（168.23±17.62）mlvs.（235.98±46.02）ml]、术后胸腔引流量（210.62±17.35）mlvs.（280.80±26.78）ml]、术后置管时间（13.33±2.29）dvs.（14.56±3.27）d]、术后平均住院时间（14.00±2.78）dvs.（16.64±2.71）d]均有显著差异（P均〈0.01）。结论 VATS手术治疗脓胸安全可靠,同时具有切口小、创伤轻、手术时间短、使用抗生素时间短、住院时间短、恢复快、无切口感染等优点。

The effectiveness of VATS vs.thoractomy for treatment of acute empyema

Objective To evaluate the effectiveness of VATS or thractomy on acute empyema. Methods The data of acute empyema patients was reviewed. Video-assisted empyema debridement and decortication were performed for 82 cases （V group）, and traditional empyema debridement and decortication were performed for 75 cases （T group） to release the compressed lung. The effectiveness and complications were compared between the two groups. Results No surgical or anesthetic complications and death happened in both groups. Compared with T group, there were shorter operation time （51.38 ±14.38）min vs. （106.07 ±46.19）min] and less bleeding during operation （168.23 ±17.62）ml vs. （235.98 ± 46.02）ml], less exudation and drainage（210.62±17.35）ml vs. （280.80±26.78）ml], shorter anti-septic and drainage duration （13.33±2.29）d vs. （14.56±3.27）d], and also shorter hospital stay （14.00±2.78）d vs. （16.64±2.71）d, P 0.01] for the V group. Conclusions The merits of VATS are mini-invasive, short operative duration, short anti-septic duration and hospital stay, and free of incision infection.