单孔胸腔镜与单操作孔胸腔镜治疗自发性气胸疗效对比研究

【目的】比较单孔胸腔镜与单操作孔胸腔镜下行肺大疱切除加胸膜固定术的临床治疗效果。【方法】回顾性分析2016年1月至2019年12月本院收治的84例自发性气胸患者,根据手术方法的不同将其分为观察组(单孔胸腔镜手术治疗,n=43)和对照组(单操作孔胸腔镜手术治疗,n=41)。记录并比较两组患者切口长度、出血量、手术时间、术后带管时间、止痛方式所占比例、术后住院时间及术后并发症发生情况。【结果】观察组切口长度、出血量显著少于对照组,差异有统计学意义(P<0.05);观察组手术时间短于对照组,但差异无统计学意义(P>0.05)。两组患者止痛方式、术后带管时间、术后住院时间比较,差异无统计学意义(P>0.05)。两组患者各有1例肺不张伴胸腔积液,予局麻下行胸腔闭式引流,抗感染并嘱患者加强呼吸锻炼后均顺利恢复,两组患者术后并发症发生情况比较,差异无统计学意义(P>0.05)。【结论】在不延长手术及住院时间且不增加手术并发症的前提下,单孔胸腔镋更符合患者对微创和美观的需求,用于治疗自发性气胸安全可靠,值得临床推广应用。

A Comparative Study on the Efficacy of Single Port VAST and single Utility Port VATS in the Treatment of Spontaneous Pneumothorax

Objective]To compare the elinical efee of single port video-ssisted thoracoscopic surgery(SP-VATS)and single utility port video assisted thoracoscopie surgery(VATS)in the treatment of pulmonary bullec-tomy with pleurodesis.Methods]A retrospeetive analysis of 84 cases of spontancous pneumothorax patients in our hospital from January 2016 to December 2019.according to the different surgical methods,they were divided into observation group(single port thoracoscopic surgery,n=43)and control group(single utility port thoracoscopic surgery,n=41).The length of incision,blood loss,operation time,postoperative catheter time,the proportion of analgesie methods.postoperative hospital stay and postoperative compliceations were recorded and compared be-tween the two groups.Results]The incision length and bleeding volume of the observation group were significantly less than those of the control group(P<0.05);the operation time of the observation group was shorter than that of the control group,but the difference was not stistically significant(P>0.05).There was no significant difference between the two groups in pain relief,postoperative catheter time and postoperative hospital stay(P>0.05).One case of atelectasis accompanied with pleural effusion occurred in two groups respectively.The patients were given closed thoracic drainage under local anesthesia,anti infection and asked to strengthen respiratory exer-cise.and all recovered smoothly.There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion]On the premise of no longer operation and hospitalization time and no increase of surgical complications,single port thoracoscopy is more in line with the needs of patients for minimally invasive and beautiful.It is safe and reliable for the treatment of spontaneous pneumothorax,which is worthy of clinical application.