摘要
目的观察单孔电视胸腔镜（VATs）治疗老年人自发性气胸的临床疗效和安全性，并与传统3孔VATS进行比较。方法选取经胸片和CT确诊为自发性气胸患者88例，随机分为单孔VATS组和传统3孔VATs组各44例。记录两组患者术中出血量、手术时间、住院时间、术后镇痛药使用时间、胸管留置时间、术后并发症和不良反应，并随访1～2年，纪录患者气胸复发情况和死亡情况。结果单孔VATS组和传统3孔VATS组老年自发性气胸患者均顺利完成胸腔镜手术，术后患者临床症状均消失，胸片示患者气胸消失。单孔VATS组与传统3孔VATS组比较，术中出血量[（46．7±18．8）ml比（61．6±19．2）ml，t=3．043、镇痛药使用时间[（1．7±0．9）d比（2．4±1．7）d，t=2．18]、住院时间[（6．3±1．7）d比（9．1±2．1）d，t=5．59]差异均有统计学意义（均P〈0．05）；手术时间、胸管留置时问亦均较传统3孔VATS组少。单孔VATS组患者术后发生胸痛11例，切口麻木7例，显著低于传统3孔VATS组（26例和21例），差异均有统计学意义（t=10．50、t2=10．26，P〈0．05）。两组患者复发率和病死率差异无统计学意义。结论单孔VATS治疗老年人自发性气胸，患者临床恢复情况较好，术后不良反应少，单孔VATS可成为老年人自发性气胸手术治疗的方法之一。
Objective To compare the clinical efficacy between single span video assisted thoracoseope （VATS） surgery and traditional VATS surgery for spontaneous pneumothorax in elderly patients. Methods A total of 88 elderly patients diagnosed as spontaneous pneumothorax by chest X-ray and CT were selected and randomly divided into single span VATS group and traditional VATS group （n=44, each）. The bleeding volume, duration of operation, hospitalization time, time of postoperative analgesic use, chest tube indwelling time, postoperative complications and adverse reactions were observed. All patients were follow-up for 1-2 years to record the recurrence rate and death rate. Results All patients were received VATS surgery successfully. Their clinical symptoms disappeared and X-ray showed that pneumothorax disappeared. There were significant differences in bleeding volume, time of postoperative analgesic use, hospitalization time between single span VATS group and traditional VATS group [（46.7±18.8）mlvs. （46.7±18.8）ml, （1.7±0.9）d vs. （2.4± 1.7）d, （6.3±1.7）d vs. （9.1±2.1）d, t=3.04, 2.18, 5.59, respectively, all P〈0.05]. The duration of operation and chest tube indwelling were shorter in single span VATS group than in traditional VATS group （both P〈0.05）. Patients with chest pain and incision numb after operation were less in single span VATS group than in traditional VATS group （11 cases vs. 26 cases, 7 cases vs. 21 cases, t 10.50, 10.26, both P〈0.05）. There were no significant differences in recurrence rate and death rate between the two groups. Conclusions Single span VATS surgery is an safe and effective treatment for spontaneous pneumothorax in elderly patients, which has a better postoperative recovery and fewer adverse reactions.
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2013年第6期643-645,共3页
Chinese Journal of Geriatrics
关键词
气胸
胸腔镜
胸外科手术
电视辅助
Pneumothorax
Thoracoscopes
Thoracic Surgery, video-assisted
