目的 探究单孔胸腔镜肺大疱切除术在自发性气胸患者中的治疗效果。方法 回顾性分析2020年1月至2023年6月期间成都大学附属医院收治的94例自发性气胸患者，按照治疗方式不同将其分为A组(50例)与B组(44例)。A组行单孔胸腔镜下肺大刨切除术，B组行双孔胸腔镜下肺大疱切除术。对比2组手术指标，术后12、24、48、72 h疼痛情况，术前与术后1周血清指标、血气指标、术后并发症及术后6个月复发情况。结果 A组手术时长高于B组，术中出血量、置管时长、胸腔引流量及住院时长均短于B组;术后12、24、48 h时，2组视觉模拟评分量表(VAS)评分均呈现降低趋势，且A组术后24 h和48 h VAS评分均低于B组;术后1周，2组TGF-β1、IL-1β、FGF-10、PaCO2水平均降低，且A组均低于B组(P＜0。05);术后1周，2组PaO2均升高，且A组高于B组(P＜0。05);2组并发症比较(8％和16％)差异无统计学意义(P＞0。05);术后随访6个月，2组总复发率比较(2％与7％)差异无统计学意义(P＞0。05)。结论 相较于双孔胸腔镜技术，单孔胸腔镜肺大疱切除术用于自发性气胸治疗更具优势，可减少术中出血量，降低术后疼痛程度，改善炎症反应与血气状态，安全可靠。
Therapeutic effect of single aperture thoracoscopic bullotomy on patients with spontaneous pneumothorax
Objective To explore the therapeutic effect of single-port thoracoscopic bullotomy on patients with spontaneous pneumothorax.Methods Ninety-five patients with spontaneous pneumothorax admitted from January 2020 to June 2023 were retrospectively analyzed and divided into group A(n=50 cases)and group B(n=44 cases)according to different treatment methods.Group A was treated with single-aperture thoracoscopic macroplanectomy,group B was treated with double-aperture thoracoscopic bullotomy.Postoperative indexes were compared between the two groups,including pain at 12,24,48 and 72 h after surgery,serum indexes,blood gas indexes before surgery and 1 week after surgery,postoperative complications and recurrence at 6 months after surgery.Results The operative time of group A was longer than that of group B,and the intraoperative blood loss,catheter insertion time,thoracic drainage and hospital stay were shorter than those of group B.At 12,24 and 48 hours after operation,visual analogue scale(VAS)scores of both groups showed a decreasing trend,and the scores of group A were lower than those of group B.One week after surgery,the levels of TGF-β1,IL-1β,FGF-10 and PaCO2 in both groups were decreased,and the levels in group A were lower than those in group B(P＜0.05).One week after operation,PaO2 was increased in both groups,and that in group A was higher than group B(P＜0.05).There was no significant difference in complications between the two groups(8％vs 16％)(P＞0.05).After 6 months of follow-up,there was no significant difference in total recurrence rate between the two groups(2％vs 7％)(P＞0.05).Conclusion Compared with double-hole thoracoscopic technique,single-hole thoracoscopic bullotomy has more advantages in the treatment of spontaneous pneumothorax,which can reduce intraoperative blood loss,reduce postoperative pain,improve inflammation and blood gas status,which is safe and reliable.
PneumothoraxSingle-aperture thoracoscopic bullotomyDegree of painBlood gas index
万方数据
维普
