摘要
目的 比较气胸治疗的三种手术方式的优缺点。 方法 回顾分析传统开胸、腋下小切口开胸、电视胸腔镜手术 (VATS)治疗气胸共 78例的住院及随诊情况。 结果 三组的术后复发例数分别为 1,1,0。传统组带管天数 (4 1± 3 1)天、引流量 (5 85 0± 5 6 4 4 )ml、杜冷丁用量 (71 7± 4 2 2 )mg、住院日 (11 8± 4 6 )天 ,在三组中最多 (F分别为 8 0 87,11 12 6 ,12 5 2 8,4 1 191;P =0 0 0 1,<0 0 0 1,<0 0 0 1,<0 0 0 1) ,VATS组带管天数 (2 1± 1 1)天、杜冷丁用量 (2 9 3± 2 8 4 )mg ,三组中最少 ,腋下组住院总费用 (75 36 0± 2 778 4 )元 ,最少 (F =5 4 79,P =0 0 0 6 )。 结论 电视胸腔镜手术治疗气胸安全、有效、微创 ,但其费用有待降低 ;腋下小切口手术较符合微创的要求 ,在特定条件下可替代胸腔镜手术 ;传统开胸手术创伤大 ,恢复慢 ,其适应证受到限制 ,但对病情复杂病例有不可替代作用。
Objective To compare the values of classic thoracotomy (CT), subaxillary mini thoracotomy (SAMT), and video-assisted thoracoscopic surgery (VATS) in the treatment of pneumothorax. Methods Postoperative parameters of 3 groups (a total of 78 patients with pneumothorax)-Group CT, Group SAMT, and Group VATS-were compared retrospectively. Results Recurrent numbers of the 3 groups were 1, 1, 0, respectively. Among the 3 groups, the Group CT had the longest drainage time ((4 1±3 1) days) and hospital stay ((11 8±4 6) days), the most drained fluid ((585 0±564 4) ml) and the maximum of Dolantin requirement ((71 7±42 2) mg) ( F =8 087, 41 191, 11 126, 12 528, respectively; P =0 001, <0 001, <0 001, <0 001, respectively). The Group VATS had the shortest drainage time ((2 1±1 1) days) and the least Dolantin requirement ((29 3±28 4) mg), while the Group SAMT had the least hospitalization expenses ((7536 0±2778 4) yuan; F= 5 479; P =0 006). Conclusions VATS is effective, minimally invasive and safe in the treatment of pneumothorax, but its expenses are subject to decline. SAMT can be an alternative when VATS is not available. CT accompanies with larger injury responses and longer recovery, but it is indispensable to complicated cases.
出处
《中国微创外科杂志》
CSCD
2003年第3期224-226,共3页
Chinese Journal of Minimally Invasive Surgery
关键词
自发性气胸
电视胸腔镜手术
腋下小切口手术
开胸手术
Spontaneous pneumothorax
Video-assisted thoracoscopic surgery
Subaxillary mini thoracotomy
Thoracotomy
