胸腔镜胸膜固定术的临床应用

目的 探讨胸腔镜胸膜固定术治疗气胸和恶性胸积液的效果。方法 对1997年9月至2003年9月间采用胸腔镜胸膜固定术治疗气胸和恶性胸积液患者30例进行回顾性分析，其中肺大泡合并自发性气胸21例，恶性胸腔积液9例。结果 本组所有患者无手术死亡。21例肺大泡患者经胸腔镜切除肺大泡并胸膜固定手术，术后平均住院时间7．4天，引流管放置时间2．8天，胸腔引流量180ml，无气胸复发。9例恶性胸腔积液患者术后平均住院时间11．2天，引流管放置时间4．4天，平均胸腔引流量420ml，随访3～16个月未见胸积液复发。结论 使用胸腔镜施行胸膜固定术具有疗效确切、创伤小的优点，可以有效地防止气胸和胸积液复发。

Clinical application of thoracoscopic pleurodesis

Objetive To investigate the effects of thoracoscopic pleurodesis i n patients with spontaneceus pneumothorax and malignant pleural effusions.Method s From September 1997 to September 2003, 30 cases with chest diseases received t horacoscopic pleurodesis were analyzed retrospectively.Results No death was foun d intraoperation in all cases.In the 21 cases with ballae of lung accompanied wi th spontaneous pneumothorax,postoperative average hospitalization time and thora cic drainage time were 7 4 days and 2.8 days respectively.The average volume of thoracic drainage was 180ml.No recurrence of pneumothorax was found.In the 9 ca ses with malignant pleural effusion,postoperative average hospitalization time a nd thoracic drainage time were 11 2 days and 4 4 days respectively.The average volume of thoracic drainage was 420 ml. With follow-up from 3 to 16 months,no recurrence of hydrothorax was found.Conclusion Thoracoscopic pleurodesis can eff ectively prevent recurrence of pneumothorax and hydrothorax,and it possesses pre cise and definite efficacy and minimally invasion.