目的 探讨目前临床常用的几种治疗自发性气胸措施的治疗效果.方法 有完整资料的自发性气胸病人157例,保守治疗组51例,手术组106例.手术组中,单纯胸腔镜下肺大疱楔形切除术58例,胸腔镜下联合管状奈维行肺大疱楔形切除术48例,术后随访为6 ～42个月,分析相关治疗的临床疗效.结果 保守治疗组与手术组的置管时间、复发情况分别是(7.05±1.85)天、9例(17％),(3.49±1.19)天、5例(4.7％),两组比较差异有统计学意义(P＜0.05),并发症比较,差异无统计学意义(P＞0.05).单纯手术组与奈维组在术后置管时间、术后并发症分别为(3.26±1.16)天、4例和(3.79±1.16)天、2例,差异无统计学意义(P＞0.05).术后住院时间及术后复发情况分别是(5.97±1.9)天、5例(8.6％)和(6.71 ± 1.91)天、0例,差异有统计学意义(P＜0.05).结论 自发性气胸易复性,对于有手术指征的病人,胸腔镜下联合管状奈维行肺大疱切除术可明显降低术后复发率.%Objective To explore the therapeutic effect of several treatments on spontaneous pneumothorax. Methods A total of 157 patients with spontaneous pneumothorax were analyzed retrospectively from Dec 2013 to Dec 2016. Among them, 51 cases were in conservative treatment group and 106 cases were in operative group; 58 cases were in video-assisted thoracoscopic surgery (VATS) bullectomy only, 48 cases were in tubular Neoveil materials combined with an automatic stapler in the bullectomy, respectively. To observe the clinical data and curative effect of the related treatment, the postoperative follow-up period ranged from 6 to 42 months. Results The rate of complications was no significant difference between the conservative and operative group. The chest tube removal time 7.05土1. 85(4～14) days vs. 3.49 ±1.19(2～7)days(P=0.000)and the rate of recurrence(9 cases: 17％ vs.5 cases:4.7％ P = 0.021) have significant differences. The chest tube removal time 3.26 ± 1.16(2～7) days vs.3.79±1.16 (2～7) days(P = 0.085) and the postoperative complications (4 cases and 2 cases, P = 0.286) have no significant difference between VATS bullectomy group and Tuber Neoveil bullectomy group. The postoperative hospital stay time was shorter than that in VATS bullectomy 5.97 ±1.9(4～16)days vs.6.71 ±1.91 (5～15)days(P=0.022). However the postoperative recurrence rate was significantly lower than that in Neoveil group(0 case)(P=0.041). Conclusion These results suggest that the use of Tuber Neoveil may be effective for the prevention of postoperative recurrence of spontaneous pneumothorax.
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