胸腔镜及其辅助小切口手术治疗老年自发性气胸的对比

目的探讨电视胸腔镜手术与其辅助小切口手术在治疗老年自发性气胸的疗效，找到一种更适合老年自发性气胸的手术治疗方法。方法56例老年自发性气胸患者分别采用VATS手术和VATS辅助小切口手术治疗，比较其围术期治疗效果、肺功能变化及1年复发率。结果本组无死亡病例，均治愈出院。VATS手术与VATS辅助小切口手术胸引管留置时间及镇痛剂使用时间、术中出血量、出院时间、术后肺功能恢复比较差别无统计学意义（P〉0．05），而两组手术时间VATS辅助小切口较VATS手术短（P〈0．05），VATS辅助小切口手术使用切割闭合器少且1年内复发率低（P〈0．05）。结论VATS辅助小切口手术适合心肺功能差且有合并症的老年自发性气胸患者。

The Treatment of Aged Spontaneous Pneumothorax with Video Assisted Thoracoscope Surgery and VATS Assisted Small Incision Surgery

Objective To discuss the treatment efficiency of thoracoscope surgery（VATS）, VATS assisted small incision surgery（VATS＋ SIS） on spontaneous pneumothorax of aged patients,so as to find out the most reasonable surgical method for the disease. Methods 56 patients with aged spontaneous pneumothorax were randomly assigned to receive VATS, and VATS＋SIS, which were defined as groups A and B respectively. The perioperative treatment efficiency,pulmonary function and recurrence rate by one year were compared among the two groups. Results All cases recovered with no mortality. Patients of two groups had no difference in thoracic drainage duration, analgesics, hospitalization, perioperative blood loss and post-operative pulmonary function（P 〉 0.05）. Apparent significance existed among two groups on the operative duration, amounts of close device and recurrence rate by one year（P〈0.05）. Conclusion VATS ＋SIS is the most reasonable surgery for the aged spontaneous pneumothorax having other complication, especially for the patients complicated with cardiopulmonary dysfunction.