目的：比较胸腔镜乳晕单孔肺大疱切除术与胸腔镜两孔法肺大疱切除术治疗青年男性气胸的临床疗效。方法我院2012年1月至2016年5月行胸腔镜下气胸手术患者79例，其中行两孔法手术22例，采用乳晕单孔法手术57例。比较两种手术方式的手术时间、手术切口大小、术后引流量、术后住院时间，采用视觉模拟评估（ VAS）进行术后第二天疼痛评估。对六个月后的疤痕满意程度进行随访调查。结果两组患者的手术时间、术后住院时间比较，差异无统计学意义（ P＞0.05）；实验组手术切口大小、术后引流量、VAS评分均低于对照组（ P＜0.05）；术后半年实验组对疤痕非常满意者有37例（71％），对照组为6例（38％），差异有统计学意义（P＜0.01）。结论胸腔镜乳晕单孔肺大疱切除术是青年男性气胸患者的较好选择。%Objective To compare the clinical outcomes of bulla ectomy for pneumothorax in young male patients under VATS by areola single-hole approach and double-hole approach.Methods Seventy-nine patients with pneumothorax received bulla ectomy under VATS between January 2012 and May.2016,in which,22 cases used double-hole approach while 57 cases used single-hole ap-proach.The mean operation time,incision length,total postoperative drainage,the mean hospital stay after surgery,and the secondary day postoperative pain score scaled by visual analog scores ( VAS) were compared between the two groups.After 6-month follow-up,the recurrence rate and scar cosmetic satisfaction evaluation were also compared.Results The differences in the operation time and post-operative hospital stay were not statistically significant between the two groups (P>0.05).The differences in the incision length,post-operative drainage and VAS scores in the double-hole approach group were significant higher than that in the single-hole approach group (P<0.05).Finally,37 patients in the single-hole approach group (71%) showed very satisfaction for scar while 6 patients in the double-hole approach group (38%) presented satisfaction.The difference was statistically significant (P <0.01).Conclusion The bulla ectomy under VATS by areola single-hole approach is a better surgical choice for young male with pneumothorax.
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