单孔法与双孔法胸腔镜肺大疱切除术治疗自发性气胸的疗效比较

目的:比较单孔法与双孔法胸腔镜下肺大疱切除术治疗自发性气胸的疗效。方法:收集2014年1月至2016年1月收治的96例自发性气胸患者,随机分为单孔组与双孔组,每组48例,比较两组临床指标、术后复发率及术后不同时间点的疼痛评分。结果:切口长度(2.24±0.28)cm vs.(4.53±0.34)cm,P=0.021]、术后胸腔引流量(120 ml vs.320 ml,P=0.008)、术后引流管留置时间(2.76±0.63)d vs.(4.62±1.24)d,P=0.037]及术后第3天(2.63±0.62)vs.(4.83±0.71),P=0.006]、3个月(1.22±0.45)vs.(2.14±0.52),P=0.016]疼痛评分单孔组显著低于双孔组。结论:单孔法胸腔镜肺大疱切除术治疗自发性气胸的疗效与双孔法相当,在技术上是安全、可行的,而且创伤更小,术后疼痛更轻,康复更快,更具优势。

Comparison of therapeutic effect between single-port and double-port thoracoscopic resection of pulmonary bullae in the treatment of spontaneous pneumothorax

Objective:To compare the clinical effects between single-port and double-port thoracoscopic resection of pulmonary bullae for patients with spontaneous pneumothorax.Methods:Ninety-six patients with spontaneous pneumothorax from Jan.2014 to Jan.2016 were selected and randomly divided into single-port group (n=48) and double-port group (n=48).The clinical indicators,postoperative recurrence rate and pain score of different time point after operation were compared between the 2 groups.Results:The operations in both groups were completed successfully.The mean length of incision (2.24±0.28) cm vs.(4.53±0.34) cm,P=0.021,thoracic tube drainage (120 ml vs.320 ml,P=0.008),drainage indwelling time (2.76±0.63) d vs.(4.62±1.24) d,P=0.037],the pain score of 3 d (2.63±0.62) vs.(4.83±0.71),P=0.006],3 months (1.22±0.45) vs.(2.14±0.52),P=0.016] after operation in single-port group were lower than those in double-port group.Conclusions:Single-port thoracoscopic resection of pulmonary bullae is technically safe and feasible and has the similar clinical effects to double-port method in the treatment of spontaneous pneumothorax.It shows an advantage over double-port procedure in less pain,fewer trauma and faster recovery.