腋下小切口及胸腔镜外科手术治疗自发性气胸的对比研究

目的 :比较电视胸腔镜手术 (VATS)与腋下小切口 (TAMT)手术治疗自发性气胸的临床效果。方法 :选择自发性气胸VATS 30例及TAMT治疗 4 3例 ,随访 2～ 18个月 ,对手术时间、胸管引流时间、胸管引流量、术后 2 4h停用强止疼药者(% )、平均住院日、术后并发症等进行分析。结果 :VATS组手术时间、胸管引流时间、平均住院日均较TAMT组明显缩短 (P<0 .0 5 ) ,胸管引流量较TAMT组明显减少 (P <0 .0 5 ) ,术后 2 4小时停用强止疼药患者 (% )较TAMT组明显增加 (P <0 .0 5 )。两组均无并发症、死亡及术后复发。结论 :电视胸腔镜手术治疗自发性气胸疗效确切 ,且创伤小、出血少、疼痛轻、手术时间短、住院时间短 ,术后恢复快 ,为自发性气胸外科治疗的首选方法。

Video-assisted thoracoscopic surgery (VATS) versus transaxillary minithoracotomy (TAMT) for the treatment of spontaneous pneumothorax

Objective:To compare the clinical results of video-assisted thoracoscopic surgery (VATS) with transaxillary minithoracotomy (TAMT) for the treatment of spontaneous pneumothorax (SP).Methods:Thirty patients were treated by VATS and 43 by TAMT.The consumed time of the operation,duration of the chest drainage,the amount of the chest drainage,the percentage of the patient without using anodyne within the postoperative 24 hour and the average time of hospitalization were compared.Results:The consumed time of the operation,the duration of the chest drainage and the average time of hospitalization were significantly shorter in group VATS than in group TAMT ( P <0.05).Amount of the chest drainage was dramatically less in group VATS than in group TAMT ( P <0.05).Percentage of patient stopped using anodyne within the postoperative 24 hours was strikingly more increased in group VATS ( P <0.05).Conclusion:VATS is curative and has many advantage,for example:minimal invasion,fewer bleeding,less pain,shorter operating time and hospitalization,quick recovery.We suggest that VATS is first choice for SP.