单孔和三孔电视胸腔镜治疗自发性气胸的对比研究

目的 探讨单孔与三孔电视胸腔镜治疗自发性气胸的临床疗效.方法 回顾性分析2012年4月-2013年4月就诊于咸阳市中心医院胸外科诊断为自发性气胸的患者58例,按照随机数字表法将患者随机分配至单孔电视胸腔镜组28例,三孔电视胸腔镜组30例,并用电话随访法进行随访.采用SPSS19.0统计学软件对两组患者的临床指标、并发症发病率及生存资料进行统计学分析.结果 与传统三孔电视胸腔镜手术相比,单孔电视胸腔镜手术具有术后住院时间更短(t=-4.151,P=0.001)、引流持续时间更短(t=-3.436,P=0.001)、切口满意度评分更高(t=-6.141,P=0.001)、术后6h疼痛视觉评分更低(t=-4.942,P=0.006)、术后24 h疼痛视觉评分更低(t=-3.326,P=0.02)及术后胸腔积液的发病率更低(Z=-2.096,P=0.036)的优点,但手术时间长(t=6.369,P=0.000),在其他并发症发病率、总生存时间(x2 =0.001,P=0.979)及中位无疾病进展生存时间(x2=1.797,P=0.180)方面差异无明显统计学意义(P＞0.05).结论 与三孔电视胸腔镜手术相比,单孔电视胸腔镜手术在住院时间短、术后疼痛轻等方面具有一定的优势,但不能明显缩短手术时间和改善患者术后生活质量.

Single-port video-assisted thoracic surgery versus three-port video-assisted thoracic surgery for primary spontaneous pneumothorax

Objective To explore the effects of single-port video-assisted thoracic surgery versus three-port videoassisted thoracic surgery for primary spontaneous pneumothorax.Methods Video-assisted thoracic surgery was performed for primary spontaneous pneumothorax in 58 patients from April 2012 to April 2013.We reviewed the medical records of these 58 patients,retrospectively.Thirty patients underwent the three-port video-assisted thoracic surgery (three-port group) and 28 patients underwent the single-port video-assisted thoracic surgery (single-port group).Following the operation,clinical outcomes,complications and overall survival were evaluated.Results There was no difference in patient characteristics between two groups.Compared with three-port videoassisted thoracic surgery,single-port video-assisted thoracic surgery had shorter hospital stay,shorter chest tube drainage,lower visual analog scale score score of 6 h postoperative pain and visual analog scale score score of 24 h postoperative pain.Meanwhile,there were no statistical differences between both groups in intraoperative bleeding,overall survival and progression-free survival.Conclusions Single-port video-assisted thoracic surgery can reduce the postoperative pain and get better clinical outcomes in treatment of primary spontaneous pneumothorax.