电视胸腔镜手术与传统开胸手术在肺部疾病治疗的临床比较

目的探索电视胸腔镜手术治疗肺部疾病的临床效果及安全性。方法将梧州市人民医院心胸外科2005年1月～2010年2月收治的71例肺部疾病患者随机应用电视胸腔镜手术或传统开胸手术治疗，其中应用电视胸腔镜手术35例，应用传统开胸手术36例，比较两组病例的手术耗时、术中出血量、胸管留置时间、术后住院时间、血清C反应蛋白（CRP）的差异以及术后并发症发生情况。结果电视胸腔镜手术组与传统开胸手术组的手术耗时分别为（150．63±35.21）、（187．47±26．38）min，术中出血量分别为（258．29±66．09）、（365．97±70．46）mL，胸管留置时间分别为（3．14±0．70）、（3．61±0．71）d，术后住院时间分别为（9．46±1．04）、（11．17±1．28）d，血清CRP术后第1、4天分别为（41．81±8．54）、（61．51±9．69）mg／L和（23．41±6．4）、（41．02±8．07）mg／L，两组比较差异均有高度统计学意义（P〈0．01）；术后两组患者均无手术死亡，电视胸腔镜手术组发生切口感染、肺不张、胸腔积液等并发症少于传统开胸手术组，但差异无统计学意义。结论电视胸腔镜手术在肺部疾病治疗中效果确切，创伤小，恢复快，并发症率低，手术安全性好．优于传统开胸手术，值得在临床推广应用。

Clinical comparison of video-assisted thoracic surgery with conventional lobectomy surgery in the treatment of lung disease

Objective To explore the clinical effect and safety of video-assisted thoracic surgery for treatment of lung diseases. Methods From January 2005 to February 2010, 71 cases in Cardiothoracic Surgery Department of Wuzhou People＇s Hospital were randomly applied video-assisted thoracic surgery or conventional lobectomy surgery treatment. 35 cases were applied to have video-assisted thoracic surgery and 36 cases were applied to have conventional lobectomy surgery. These two groups were made comparison in operation time, intraoperative bleeding, chest tube indwelling time, postoperation hospitalization duration, levels of serum C-reaction protein （CRP） and postoperative complications. Results Operation time of Video-as- sisted thoracic surgery group and conventional lobectomy surgery group were （150.63±35.21） min and （187.47±26.38） rain. Blood loss during operation were （258.29±66.09） mL and （365.97±70.46） mL. Chest tube retention time of the two groups were （3.14±0.70） d and （3.61±0.71） d. Postoperative hospitalization time of the two groups were （9.46±1.04） d and （11.17±1.28） d. Levels of serum CRP of the two groups on the first day were （41.81±8.54） mg/L and （61.51±9.69） mg/L, which on fourth day were （23.41±6.4） mg/L and （41.02±8.07） mg/L. The two groups were statistically significant （P 〈 0.01）, whose patients had no operation death. Incision infection, atelectasis and pleural effusion occurred in video-assisted thoracic surgery group were less than conventional lobeetomy surgery group, in which there were no statistical significance. Conclusion Video-assisted thoracic surgery with small trauma, quick recovery, low complication rate, operation safety and superior to conventional lobectomy surgery, is an effective method for treatment of lung disease. It is valuable to advocate clinically.