自发性血气胸25例外科治疗

摘要

目的 探计自发性血气胸外科治疗的手术适应证和优越性.方法 25例自发性血气胸患者中采用电视胸腔镜手术治疗9例为胸腔镜手术组,小切口开胸手术治疗16例为小切口开胸手术组,比较2组平均手术时问、术后住院天数及留置胸引管天数等因素.结果 胸腔镜手术组平均手术时间(72.7±16.8)min,术后留置胸引管(5.6±5.6)d,术后住院(10.2±5.4)d,有1例因术后持续漏气需要二次手术.小切口开胸手术组平均手术时间(68.4±13.6)min,术后留置胸引管(3.5±1.9)d,术后住院(7.8±2.5)d.2组在手术时间、术后留置胸引管天数、术后住院天数上均无统计学意义.全部患者均痊愈出院,术后随访3～12个月,无血气胸复发.结论 对于自发性血气胸早期进行外科手术治疗,可减少并发症,缩短住院周期,提高生活质量.%Objective To observe advantages of surgical treatment for patients with spontaneous hemopneumothorax.Methods From Jan 1997 to Oct 2007,25 patients with spontaneous hemopneumothorax were treated,ranged from 19 to 34 years old(average 23.2 years),including 24 males and 1 female.11 patients had lesions on the left side,others on the right side.When treated,9 patients got VATS,16 patients got minithoracotomy.Results In VATS group.the average operation time wag(72.7±16.8)minutes.The average postoperative drainage time Wag(5.6±5.6)days,and the average postoperative hospital days were(10.2±5.4)days.1 patient needed the second operation for persistent postoperative air leak.In minithoracotomy group.the data Wag(68.4±13.6)minutes,(3.5±1.9)days,and(7.8±2.5)days.There was no significant difference between the two groups in operation time,postoperative drainage time and postoperative hospital days.All patients were followed up for 3 to 12 months.Conclusion Patients with spontaneous hemopneumothorax having surgical treatment show less morbidity,shorter hospitalization,less medical cost and better life quality than the conservative therapy.