单孔胸腔镜肺大疱切除术治疗自发性气胸的疗效及中期随访研究

为了探讨单孔胸腔镜肺大疱切除术在自发性气胸中的治疗效果及安全性,本研究选取自发性气胸患者70例,根据随机数字表法将患者分为对照组(n=35)与研究组(n=35)。研究组采取单孔胸腔镜肺大疱切除术,对照组采取双孔胸腔镜肺大疱切除术。统计两组手术情况(手术时长,术中失血量,术后引流量,留置引流管时间,住院时间)、术后(术后即刻,术后12 h,术后24 h)疼痛程度(VAS)分值、并发症发生率,随访6~12个月,统计两组疾病复发率。研究显示,研究组手术时长与对照组间无明显差异(p>0.05),研究组术中失血量、术后引流量少于对照组,留置引流管时间及住院时间短于对照组(p<0.05);术后即刻两组VAS分值间无明显差异(p>0.05),研究组在术后12 h及24 h的VAS分值低于对照组(p<0.05);研究组并发症发生率(5.71%)与对照组(8.57%)间无明显差异(p>0.05);研究组在术后6个月、9个月、12个月的疾病复发率(2.86%,8.57%,11.43%)与对照组(5.71%,14.29%,17.14%)比较无明显差异(p>0.05)。本研究表明,采取单孔胸腔镜肺大疱切除术治疗自发性气胸,可减少手术创伤,缩短术后康复及住院时间,减轻疼痛程度,且并发症发生率及疾病复发率较低。

Curative Effect and Mid-term Follow-up of Spontaneous Pneumothorax Treated with Single-hole Thoracoscopic Bullectomy

In order to investigate the treatment effect and safety of single-hole thoracoscopic bullectomy in the treatment of spontaneous pneumothorax,a total of 70 cases of spontaneous pneumothorax were selected and divided into the control group(n=35)and the study group(n=35)according to the random number table method.The study group was treated with single-hole thoracoscopic bullectomy and the control group was treated with double-hole thoracoscopic bullectomy.The operative condition(operative time,intraoperative blood loss,postoperative drainage volume,time of detaining drainage tube,hospitalization time),pain degree(VAS)after operation(immediately after operation,12 h after operation,24 h after operation)and complication rate were statistically analyzed in two groups.After 6~12 months of follow-up,the recurrence rate of the two groups was statistically analyzed.Results showed that there were insignificant differences in the operation time between the control group and the study group(p>0.05).The intraoperative blood loss and postoperative drainage volume of the study group were less than those of the control group,and the time of detaining drainage tube and the time of hospitalization were shorter than those of the control group(p<0.05).There were insignificant differences between the two groups in VAS scores immediately after the operation(p>0.05).The VAS score after 12 h and 24 h of operation in the study group was lower than that in the control group(p<0.05).There were insignificant differences in the incidence of complications between the study group(5.71%)and the control group(8.57%)(p>0.05).There were insignificant differences in the recurrence rate of disease after 6,9 and 12 months of operation between the study group(2.86%,8.57%,11.43%)and the control group(5.71%,14.29%,17.14%)(p>0.05).This study indicates that Single-hole thoracoscopic bullectomy in the treatment of spontaneous pneumothorax could reduce the surgical trauma,shorten the time of postoperative recovery and hospitalization,reduce the degree of pain,and the incidence of complications and the rate of disease recurrence are relatively low.