临床外科杂志 ›› 2019, Vol. 27 ›› Issue (7): 574-576.doi: 10.3969/j.issn.1005-6483.2019.07.011

• 论著 • 上一篇    下一篇

腋前线第4肋间与腋中线第7肋间单孔胸腔镜治疗原发性自发性气胸的临床疗效比较

  

  1. 广东省深圳市南山区人民医院胸外科
  • 出版日期:2019-07-20 发布日期:2019-07-20

The comparative analysis of the effect of Videoassisted thoracoscopic surgery of Pulmonary Bullae resection for primary spontaneous pneumothorax by uniport in the 4th anterior axillary intercostal space and the 7th mid axillary intercostal space

  • Online:2019-07-20 Published:2019-07-20

摘要: 目的:比较腋前线第4肋间与腋中线第7肋间单孔胸腔镜肺大疱切除术治疗原发性气胸的疗效。方法:单侧原发性自发性气胸病人96例,按治疗方式不同分为两组。第4肋间组37例,取腋前线第4肋间为手术切口;第7肋间组59例,取腋中线第7肋间为手术切口,切口长度均为2cm。分析两组术中及围手术期各指标的差异。结果:两组均无改为多孔、中转开胸、死亡、术后感染、胸腔感染等事件发生。腋前线第4肋间单孔胸腔镜组的住院时间,术后引流量,手术时间,胸腔引流管留置时间,术后漏气时间及疼痛时间、住院费用显著低于第7肋间手术组(P<0.05)。两组术中出血量比较差异无统计学意义(P>0.05)。第4肋间组术中应用切割缝合器的个数少于第7肋间组,差异有统计学意义(P<0.05);第4肋间组丝线结扎肺大疱个数多于第7肋间组,差异有统计学意义(P<0.05)。结论:腋前线第4肋间单孔胸腔镜手术治疗原发性自发性气胸可行、可靠。

关键词: 单孔胸腔镜, 肺大疱, 自发性气胸, 腋前线第4肋间, 腋中线第7肋间

Abstract: Objective:To compare the results of the two different uniport locations between the 4th anterior axillary intercostal space and the 7th mid axillary intercostal space to develop a better surgical approach.Methods:Nintysix patients with unilateral primary spontaneous pneumothorax were treated with uniport VATS operation. They were divided into two groups, 37 cases of which took the anterior axillary line of the 4th intercostal space as the surgical incision, and 59 cases of them took the middle axillary line of the 7th intercostal as the surgical incision,the incision length was 2cm.The perioperative indicators differences were analyzed by statistical method.Results: None case with complications appeared from uniport to multiport, opening the chest, death, postoperative infection and chest infection. There were significant differences in the hospital stay, the amount of drainage, operation time, the time of chest drainage tube keeping, the time of pleural leakage, pain duration after operation, and hospitalization cost (P<0.05).The number of surgical stapler in the 4th intercostal group was less than the 7th intercostal group, the number of pulmonary bulla ligation in the 4th intercostal group was more than the 7th intercostal group(P<0.05).Conclusion:The study indicated that uniport VATS in the 4th anterior axillary intercostal space for the treatment of primary spontaneous pneumothorax is feasible and reliable, and can be used as a priority way.

Key words: videoassisted thoracoscopic surgery;pulmonary bullae;primary spontaneous pneumothorax, the 4th anterior axillary intercostal space, the 7th mid axillary intercostal space

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