胸腔镜下2孔与3孔行先天性肺大疱切除术效果比较

目的：比较电视胸腔镜下2孔与3孔行先天性肺大疱切除术的临床效果。方法选取先天性肺大疱患者38例，均在电视胸腔镜下行先天性肺大疱切除术，根据胸腔镜操作孔数分为两组，观察组19例采用2孔操作，对照组19例采用3孔操作，比较两组手术时间、术后拔胸管时间、术后平均住院时间、术后镇痛药应用情况。结果观察组手术时间、术后拔胸管时间、术后平均住院时间、镇痛药应用率分别为（46．89±9．11）min、（3．9±0．8）d、（7．3±1．3）d、21．1％，对照组分别为（66．05±12．09）min、（4．3±0．9）d、（7．3±1．5）d、52．6％，两组手术时间、镇痛药应用率差异均有统计学意义（t＝－5．516，χ^2＝4．071，均P＜0．05）；38例均治愈出院，随访3～24个月无1例复发。结论电视胸腔下行先天性肺大疱切除术2孔较3孔更加微创，手术时间短、术后镇痛药应用率低。

Comparison of thoracoscopic 2 hole and 3 hole for congenital pulmonary bulla resection

Objective To compare the effects of thoracoscopic 2 hole and 3 hole for congenital pulmonary bulla resection.Methods 38 cases of congenital pulmonary bulla patients,both in the VATS downlink congenital pulmonary bulla resection.According to the number of holes,thoracoscopic operation were divided into the two groups. To observe the use of group 19 cases of 2 holes,19 cases 3 holes were adopted in the control group.Pull the chest tube operation time,operation time of the two groups were compared after.and the average hospitalization time after opera-tion,postoperative analgesia drug application.Results The observation group operation time,operation time,pulling the chest tube after operation the average hospitalization time, analgesic drug application rate respectively were （46.89 ±9.11）min,（3.95 ±0.85） d,（7.37 ±1.34） d,21.1%,The control group were （66.05 ±12.09） min, （4.37 ±0.98）d,（7.32 ±1.57）d,52.6%.There were statistically significant differences in rate of the two groups in operation time,analgesic drug application.（t=-5.516,χ^2 =4.071,P〈0.05）;38 cases were cured,followed up for 3-24 months,no recurrence occurred in 1 cases.Conclusion Video assisted thoracic descending congenital pulmona-ry bulla resection,the 2 hole 3 hole more than minimally invasive,short operation time,postoperative analgesic use rate is low.