电视胸腔镜手术治疗血气胸200例报告

目的总结电视胸腔镜手术（video-assisted thoracoscopic surgery，VATS）治疗血气胸的体会。方法自发性气胸肺大泡结扎或切除170例和自发性或创伤性血气胸紧急探查止血30例。结果185例经胸腔镜完成手术，12例附加胸部小切口，3例中转开胸手术。术后并发症17例，占8．5％（17／200），其中肺泡漏9例，复张性肺水肿6例，胸腔感染2例。2例术后3～4个月自发性气胸复发。结论VATS治疗自发性气胸肺大泡和自发性或创伤性血气胸较传统开胸手术具有更多优点，适时附加胸部小切口，积极防治并发症，可使VATS更安全。

Experience of Video-assisted Thoracoscopic Surgery in 200 Patients for Hemopeumothorax

Objective To summarize the clinical experience of video-assisted thoracoscopic surgery （VATS） for hemopneumothorax. Methods There are 170 cases of spontaneous pneumothorax undergoing pulmonary bubble ligation or resection and 30 cases of spontaneous or traumatic hemopneumothorax undergoing urgent exploration hemostases. Results Surgical procedures were completed by VATS in 185 cases, by VATS combined with minithoractomy in 12 cases, and were converted to thoractomy in 3 cases. Postoperative complications occurred in 17 cases with a morbidity rate of 8. 5 （17/200）. Persistent air leakage occurred in 9 cases, reexpansion pulmonary edema occurred in 6 casesand infections of thoracic cavity occurred in 2 cases. Spontaneous pneumothorax reoccurred in 2 patients 3-4 months postoperatively. Conclusion VATS has more advantages over traditional thoractomy for the treatment of spontaneous pneumothorax pulmonary bubble and traumatic hemopneumothorax. The combination with minithoractomy under certain circumstance helps to improve the safety of VATS.