摘要
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。方法 1993年 12月～ 2 0 0 2年5月施行VATS手术 6 71例 (70 1次 ) ,6 4 8例经VATS完成手术 ,2 3例改为传统开胸手术。术式包括肺大疱切除 347例 ,食管疾病手术 82例 ,纵隔肿瘤或囊肿切除 5 8例 ,肺叶切除或肺楔形切除 88例 ,胸外伤止血和多发肋骨骨折固定术 18例 ,心包开窗和胸膜手术 2 3例 ,胸部疾病活检术 32例。结果 并发症 2 8例 ,占 4 .2 %。其中术中并发症 8例 ,包括食管黏膜破裂 3例 ,神经损伤 2例 ,3例术中止血不彻底术后出血。术后并发症 2 0例 ,包括肺泡漏≥ 7d 16例 ,胸腔积液和积气再次置闭式引流管 2例 ,房颤和胸腔感染各 1例。 1例自发性气胸Ⅱ型呼衰病人 ,术后呼衰未能得到纠正 ,第 5天死亡。结论 胸腔镜是胸外科领域新的手术方法 ,只有注意预防和减少并发症的发生 ,才能使其得到进一步的推广使用。
Objective:To summary the experience of prevention the complication of video-assisted thoracoscopic surgery and to generalize this skill.Methods: Six hundred and seventy-one patients (701 times) were performed thoracoscopic surgery in our hospital from December 1993 to May 2002.Including bullectomy in 347 patients,esophageal diseases in 82,resection of mediastinal tumor or cyst in 58;lobectomy or wedgeresection of lung in 88,hemostasis or fixation of multiple rib fracture for chest injure in 18,partial pericardial or pleural excision in 23 and biopsy for chest diseases in 32.Results: Complications occured in 28 (4.2%);Eight occured during the procedure,including esophageous mucous rupturein 3,nerve injury in 2,and insufficient hemostasis leading to postoperative bleeding in 3 cases;Twenty occured postoperatively,including persistent air leak (over 7days) in 16,pleural effusion or pneumothorax needing a second water-closed drainage in 2,atrial fibrillation in 1 and infection of thorax in 1. One case with spontaneous pneumothorax and type II respiratory failure died of repiratory failure on the fifth day postoperatively. Conclusion: VATS is a new skill of thoracic surgery. More attentions must be payed to prevent and reduce complication in order to generalize the use of it.
出处
《中国内镜杂志》
CSCD
2004年第2期8-10,共3页
China Journal of Endoscopy
关键词
电视胸腔镜
并发症
手术
video-assisted thoracoscopy
complication
operation
