单孔和双孔胸腔镜膜纤维板切除术治疗包裹性胸腔积液的效果

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摘要目的探讨单孔和双孔胸腔镜膜纤维板切除术治疗包裹性胸腔积液的效果。方法回顾性分析2010年4月～2015年4月于延安市人民医院诊断为包裹性胸腔积液的患者135例的临床资料，按照手术方法分为单孔胸腔镜组（单孔组，45例）、双孔胸腔镜组（双孔组，53例）、开胸手术组（传统组，37例）。对三组患者的临床指标、并发症发生率进行分析和比较。结果三组患者临床指标比较，单孔组具有切口长度最短（F = 8585.958，P = 0.000）、术中出血量最少（F = 686.322，P = 0.000）、术后住院时间最短（F = 406.947，P =0.000）、引流持续时间最短（F = 95.563，P = 0.000）、切口满意度评分最高（F = 68.241，P = 0.000）、术后6 h 视觉模拟评分（VAS）评分最低（F = 90.219，P = 0.000）、术后24 h VAS评分最低（F = 263.125，P = 0.000）的优点。此外，单孔组的肺不张发生率（χ2 = 17.667，P = 0.000）和切口感染发生率（χ2 = 13.841，P = 0.001）均显著低于双孔组和传统组。且术后切口恢复图片显示单孔组术后两周恢复状况较好于双孔组和传统组。结论相较于双孔胸腔镜手术和传统开胸手术，单孔胸腔镜手术具有一定的优势，能明显提高治疗包裹性胸腔积液的疗效。

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	李鹏飞1 尚娜2 王延军1

关键词 ：单孔胸腔镜, 双孔胸腔镜, 传统开胸, 包裹性胸腔积液

Abstract：Objective To explore the effect of single-port and double-port thoracoscopic fibrostectomy treating of encapsulated pleural effusion. Methods From April 2010 to April 2015, in Yan′an People′s Hospital, the clinical data of 135 patients with encapsulated pleural effusion were retrospectively analyzed, according to the operation method, they were divided into three groups, single-port thoracoscopic fibrostectomy group (single-port group, 45 cases), double-port thoracoscopic fibrostectomy group (double-port group, 53 cases), open-thoracic operation (tradition group, 37 cases). The clinical outcomes and complications of three groups were analyzed and compared. Results The clinical indicators of three groups were compared, single-port group patients had the shortest incision length (F = 8585.958, P = 8585.958), the least intraoperative blood (F = 686.322, P = 0.000), the shortest hospital stay (F = 406.947, P = 0.000), the shortest chest tube drainage (F = 95.563, P = 0.000), the highest score of incision satisfaction score (F = 68.241, P = 0.000), the lowest VAS score of 6 h postoperative pain (F = 90.219, P = 0.000) and he lowest VAS score of 24 h postoperative pain (F = 263.125, P = 0.000). Meanwhile, the incidence of atelectasis (χ2 = 17.667, P = 0.000) and incisional infection rate (χ2 = 13.841, P = 0.001) of the single-port group were significantly lower than the double-port group and traditional group. The postoperative incision pictures showed that two weeks recovery state after the operation of the single-port group were better than the double-port group and the traditional group. Conclusion Compared with double-port thoracoscopy and traditional open-thoracic surgery, single-port thoracoscopic surgery has certain advantages, which can obviously improve the curative effect to treat encapsulated pleural effusion.

Key words： Single-port thoracoscopy Double-port thoracoscopy Traditional open-thoracic operation Encapsulated pleural effusion

基金资助:陕西省延安市科技惠民计划（2015M-06-02）。

引用本文:

李鹏飞1 尚娜2 王延军1. 单孔和双孔胸腔镜膜纤维板切除术治疗包裹性胸腔积液的效果[J]. 中国医药导报, 2018, 15(10): 79-82.
LI Pengfei1 SHANG Na2 WANG Yanjun1. Curative effect of single-port and double-port thoracoscopic pleural fiberboard treating encapsulated pleural effusion. 中国医药导报, 2018, 15(10): 79-82.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2018/V15/I10/79

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