胸腔镜在陷闭肺综合征手术治疗中的应用

目的：探讨陷闭肺综合征合理的手术治疗方法，方法：24例陷闭肺病例均作胸腔镜探查，纤维板剥脱术，其中6例凝固性血胸需行肺楔形切除，6例支气管胸膜瘘作带蒂大网膜转移术修补，3例乳糜胸需作胸导管结扎术，3例脓胸需作带蒂大网膜转移术，2例食道自发性破裂作带蒂大网膜转移修补术，2例结核毁损肺作左侧全肺切除，2例肺癌行左全肺切除，结果：全部病例症状缓解，无术后并发症。结论：陷闭肺的治疗要实施个体人方案，胸腔镜手术可提供准确的诊断同时可施行清创术和纤维板剥脱术，纤维板剥脱术是治疗肺萎陷的最有效术式，带蒂大网膜转移术对瘘的治疗成功率高。

Application of thoracoscope in Surgical treatment of Trapped Lung Syndrome

Objective: To establish a reasonable surgical methods for trapped lung syndrome. Methods: Twenty - four patients with trapped lung syndrome underwent diagnostic thoracoscopy and decortication of lung. Wedge resection of the lung was performed in 6 cases of clotted hemothorax. Transposition of pedicled omentum was performed in 6 cases of bronchopleural fistula, 3 cases of empyema and 2 cases of spontaneous rupture of esophagus. Pneumonectomy was performed in 2 cases of tuberculous empyema and parenchymal necrosis and 2 cases of lung cancer. Results: Symptomes were relieved in all cases and no postoperative complication was found. Conclusions: Surgical management for trapped lung syndrome depends on different situations of each individual. Thoracoscopy provides an accurate diagnosis and allows debridement and decortication of lung to be performed. Decortication remains the most effective treatment for trapped lung, and transposition of pedicled omentum is highly effective in the treatment of bronchopleural fistula.