电视胸腔镜在胸部疾病诊治中的应用体验

目的探讨电视胸腔镜在胸部疾病诊断和治疗中的应用。方法对46例胸部疾病进行胸腔镜诊治,肺病灶活检4例,胸膜活检2例,气胸修补或(及)肺大疱切除9例,肺病灶契形切除3例,肺叶切除26例,结核性包裹性胸腔积液清除2例。结果本组无手术死亡。中转开胸1例,术后血胸再进胸止血1例。术中失血量,平均306 ml。拔除胸引管时间,平均5.9 d。手术至出院时间,平均13.5d。术后肺泡炎2例,经抗感染、对症及保持胸引管通畅等治愈。随访2个月~1年,无术后近远期支气管胸膜瘘、气胸肺大疱复发及肺癌转移等并发症。结论电视胸腔镜在胸部疾病诊治中的应用范围广、疗效好,创伤小。

The video-assisted thoracoscopy in diagnosis and treatment of chest diseases

Objective To study the video-assisted thoracoscopy in diagnosis and treatment of chest diseases.Methods All 46 cases of chest disease were treated with video-assisted thoracoscopic surgery(VATS),including 4 cases of lung lesion biopsy,2 cases of pleural biopsy,9 cases of pneumothorax repairing or / and pulmonary bullous resection,3 cases of pulmonary lesions wedgeresection,26 cases of pulmonary lobectomy and 2 cases of cleared packaged tuberculous pleural effusion.Results There was no death in surgery.There was one case of conversion to thoracotomy,one case of stanching bleeding for a second time after thoracotomy.The average blood loss was 306 ml.Average time of removing the chest tube was 5.9 days.Average time from surgery to discharge was 13.5 days.Two cases of alveolitis happened,which were cured by anti-inflammatory and symptomatic treatment and keeping the chest tube patency.Followed-up for 2 months to 1 year,the patients showed no long or short term bronchopleural fistula,pneumothorax or bullae recurrence,metastasis of lung cancer and other complications.Conclusion Video-assisted thoracoscopy has wider application,better efficacy and smaller trauma in the diagnosis and treatment of chest diseases.