电视胸腔镜手术并发症的分析与对策

目的总结预防胸腔镜手术并发症的方法，推广电视胸腔镜手术（VATS）。方法我科实施VATS手术376例，368例经VATS完成手术，8例改为传统开胸手术。术式包括肺大疱切除214例，食管疾病手术4例，纵隔肿瘤和囊肿切除2例，肺叶切除或肺楔形切除31例，胸外伤止血和／或肺叶修补72例，胸膜活检和固定术45例，心包开窗引流7例。结果并发症29例（7．9％）。其中术中并发症6例，术后并发症23例，2例自发性气胸Ⅱ型呼衰患者，术后呼衰未能纠正死亡。结论胸腔镜是胸外科一种新的手术方法，只有注重预防，才能减少并发症的发生，使其得到进一步的推广。

Analysis and Prevention of Complications of Video-Assisted Thoracic Surgery

Objective To summarize the experience of preventing the complications of video-assisted thoracic surgery and to generalize this skill. Methods 376 cases of video-assisted thoracic surgery included bullectomy（214 cases）, esophagus diseases （ 4 cases ）, resection of mediastinal tumor or cyst （ 2 cases ）, lobectomy or wedgeresection of lung （ 31 cases ）, hemostasis or lobere- pair for chest injure（72 cases） ,pleural biopsies and pleurodesis（45 cases） ,drains of pericardiotomy（7 cases） ,and 8 cases conversed to open procedures. Results 29 （7.9%） cases of the operations had complications, six of them happened during the video-assisted thoracic surgery. Those were bleeding of vesinjary. 2 patients with spontaneous pneumothorax and type Ⅱ respiratory failure died. Conclusion Video-assisted thoracic surgery is a kind of new thoracic surgery,its complications can be reduced by prevention.