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1、臨床肺科雜志2017年1月第22卷第1期69內(nèi)科胸腔鏡在自發(fā)性氣胸中的應(yīng)用12111張晶雷軍榮羅國(guó)仕魏娜雷懷定【摘要】目的探討內(nèi)科胸腔鏡在自發(fā)性氣胸中的應(yīng)用效果。方法分析37例持續(xù)漏氣5天以上的自發(fā)性氣胸患者，其中15例接受了內(nèi)科胸腔鏡手術(shù)，22例接受了閉式胸腔引流術(shù);主要分析指標(biāo)包括術(shù)后引流時(shí)間、術(shù)后住院時(shí)間、出現(xiàn)復(fù)張性肺水腫例數(shù)、術(shù)后24小時(shí)疼痛評(píng)分以及兩組病人術(shù)后肺與胸膜并發(fā)癥、轉(zhuǎn)開(kāi)胸手術(shù)例數(shù)、1年內(nèi)氣胸復(fù)發(fā)例數(shù)。結(jié)果與單純閉式胸腔引流術(shù)組相比，內(nèi)科胸腔鏡手術(shù)組術(shù)后引流時(shí)間［(4.13±1.46)vs(12.41±6.96)，P=0.000］、術(shù)后住院時(shí)間［(7.
2、47±4.42)vs(16.08±8.64)，P=0.000］、出現(xiàn)復(fù)張性肺水腫例數(shù)［(0)vs(5%)，P=0.028］明顯下降，差異具有統(tǒng)計(jì)學(xué)意義;兩組患者在術(shù)后24小時(shí)疼痛評(píng)分、肺與胸膜并發(fā)癥、轉(zhuǎn)開(kāi)胸手術(shù)及1年內(nèi)氣胸復(fù)發(fā)例數(shù)等方面差異均無(wú)統(tǒng)計(jì)學(xué)意義(均P＞0.05)。結(jié)論對(duì)于持續(xù)漏氣的自發(fā)性氣胸，相比單純的閉式胸腔引流術(shù)，內(nèi)科胸腔鏡手術(shù)具有更好的治療效果，能顯著縮短患者住院時(shí)間?！娟P(guān)鍵詞】?jī)?nèi)科胸腔鏡;自發(fā)性氣胸;住院時(shí)間ApplicationofinternalthoracoscopyonpatientswithspontaneouspneumothoraxZHA
3、NGJing，LEIJun-rong，LUOGuo-shi，WEINa，LEIHuai-dingDepartmentofＲespiration，TaiheHospitalAffiliatedtoHubeiUniversityofMedicine，Shiyan，Hubei442000，China【Abstract】ObjectiveTodiscusstheapplicationeffectofinternalthoracoscopyonspontaneouspneumotho-rax．MethodsAretrospectiveanalysiswasconductedon3
4、7patientswithspontaneouspneumothoraxwhowerecon-tinuousairleakageandlastedmorethan5days，including15caseswerehadinternalvideo-assistedthoracicsurger-y，and22casesweretreatedwiththeclosedthoracicdrainage．Themainanalysisindicatorsincludedpostoperativedrainageduration，postoperativehospitalizat
5、ion，re-expansionpulmonaryedema，painscorewith24hoursafteropera-tion，whosufferedlungandpleuralcomplicationafteroperation，andthecaseswhichweregonetoopenchestopera-tionandrecurrencepneumothoraxwithin1year．ＲesultsComparedwiththeconventionalclosedthoracicdrainagegroup，drainagetime［(4.13±1.46)v
6、s(12.41±6.96)，P=0.000］，hospitalstayafteroperation［(7.47±4.42)vs(16.08±8.64)，P=0.000］，thecasesofre-expansionpulmonaryedemaafteroperation［(0)vs(5%)，P=0.028］oftheinternalvideo-assistedthoracicsurgerygroupdecreasedobviously．Therewasnosignifi-cantdifferenceinVASscoreofpostoperative24h，lungand
7、pleuralcomplicationafteroperation，anthecaseswithopenchestoperationandrecurrencepneumothoraxwithin1yearbetweenthetwogroups(P＞0.05)．ConclusionThestudyshowsthatinternalvideo-assistedthoracicsurgeryissuperiortoconventionalclosedthoracicdrainageinthetreatmentofspontaneouspneum
