电视胸腔镜自体血回输治疗自发性血胸和血气胸

目的探讨电视胸腔镜手术（VATS）结合自体血回输治疗自发性血胸、血气胸的疗效。方法 25例自发性血胸和血气胸患者,采用VATS治疗,并在术中同步进行自体血回输。观察失血量和回输血量,检测术前、术后第1天及第7天的血常规、凝血功能及肾功能。结果 25例患者均经胸腔镜完成胸腔积血回收,血凝块清除;胸腔止血和肺大疱切除。术中出血量（1610＋730）ml,回收血量（1235＋485）ml,术后血红蛋白和红细胞总数均较术前有显著增加;除2例病人术后胸腔引流管放置时间较长外,全组无死亡,均痊愈出院。结论电视胸腔镜手术治疗自发性血胸和血气胸,创伤小,恢复快;结合术中自体血回输可以及时补充血容量,节约血源,显著减少各种输血并发症,增加抢救成功率。

Treatment of spontaneous haemothorax and hemopneumothorax by video-assisted thoracoscopic surgery and autologous transfusion

Objective To evaluate the efficacy of video-assisted thoracoscopic surgery（VATS） and autologoustrans fusion for spontaneous haemothorax and hemopneumothorax.Matearials All the 25 actue haemothorax and hemopneumothorax patients who underwent VASTS and autologous transfusion were retrospectively studied.The clinical parameters of pre-operation,first day and 7th day after operation were collected,including RBC,Hb,Hct,Plt,PT,APTT,BUN and Cr.Results The intraoperative hemorrhage volume of the 25 patients was（1610 ＋ 730） ml,and the volume of blood recovery was（1235 ＋ 485） ml.The post-operative RBC,Hb and Plt were significantly higher than the preoperative parmeters.There were no severe surgery or transfusion-related complications in the entire study group.Conclusion VATS can be performed for safely the management of haemothorax and autologous transfusion can effectively decrease the complications of homologous transfusion.