胸腔镜手术治疗COPD合并自发性气胸的临床疗效观察

目的：探讨胸腔镜手术治疗慢性阻塞性肺疾病（COPD）合并自发性气胸的临床疗效和安全性。方法：回顾性分析胸腔镜手术治疗的患者46例（观察组）和传统开胸手术治疗的患者30例（对照组），比较二者的手术一般情况、肺功能指标和并发症。结果：观察组患者在手术时间、术中出血量、术后疼痛时间、引流置管时间和住院天数等方面，均优于对照组，差异存在统计学意义（P〈0．05）。两组患者治疗前FVC、MVV和FEVl等肺功能指标比较，差异均无统计学意义（P〉0．05）；术后2周，两组患者FVC、MVV和FEVl较治疗前均好转（P〈0．05），但是观察组变化幅度更显著，差异存在统计学意义（P〈0．05）。观察组患者并发症发生率为6．52％，明显低于对照组的23．33％，二者差异存在统计学意义（P〈0．05）。结论：胸腔镜手术治疗COPD合并自发性气胸效果显著，手术创伤小，患者恢复快，是一种治疗COPD合并自发性气胸安全、有效的方法，值得临床推广应用。

Observation on the Effects of Thorascopic Surgery on Patients with COPD Combined with Spontaneous Pneumothorax

Objective： To investigate the clinical therapeutic effects and safety of thorascopic surgery in treatment of COPD combined with spontaneous pneumothorax. Method： 46 patients underwent thorascopic surgery （ observation group ） and 30 patients underwent traditional thoracotomy （control group ）were retrospectively analyzed, and the general operative condition, lung function index and complication of the two groups were compared. Result： The operative time, intraoperative hemorrhage volume, postoperative paintime, drainage tube retention time, and length of hospital stay of the observation group were all better than thisein the control group, and the differences were statistically significant （ P〈0.05 ）. The differences in preoperative lung function indexes such as FVC, MVV and FEV1 between the two groups were statistically insignificant （P〉0.05 ） ; 2 weeks after the operations, FVC, MVV and FEV1 were all improved when compared before the therapies （ P〈0.05 ）, but those of the observation group were improved more significantly, and the differences were statistically significant （ P〈0.05 ）. The incidence of complications of the observation group was 6.52%, It was significantly lower than that of the control group （23.33%）, and the difference between the two group was statistically significant （P 〈0.05 ）. Conclusion： Thorascopic surgery in treatment of COPD combined with spontaneous pneumothorax is significantly effective, with less wound and rapid recovery, is a safe and effective method for treating COPD combined with spontaneous pneumothorax, and consequently is worthy of clinical application.