摘要
探讨并总结胸腔镜手术治疗某些胸部疾病的体会。 1993年 12月～ 2 0 0 1年 12月开展胸腔镜手术 616例 ,手术 64 4次。 2 3例因为胸腔粘连或肿瘤外侵改为开胸手术 ,5 93例经胸腔镜完成手术 ,其中自发性气胸肺大疱切除 2 76例 ,肺气肿肺大疱切除 44例 ,纵隔肿瘤和囊肿切除 5 5例 ,食管疾病手术 78例 ,肺良恶性疾病手术 75例 ,其他手术 65例。麻醉采用双腔管气管插管 5 76例 ,单腔管气管插管双肺通气 3 4例、单肺通气 6例。术后并发症 2 4例 ,占 4 0 % ,其中肺泡漏带引流管超过 7天者 15例 ,术后出血 3例 ,自发性气胸Ⅱ型呼衰病人 1例 ,其他并发症 5例。自发性气胸肺大疱切除的 2 76例获随访 ,其中 4例复发。结果表明 ,某些胸部疾病胸腔镜治疗比传统开胸手术有更多优点 ,胸外科医生应逐渐改变传统剖胸手术观念 。
To evaluate and summary clinical experience in video assisted thoracoscopic surgery (VATS)for some thoracic diseases, clinical data of 616 patients (644 times) subjected to thoracoscopic surgery in our hospital from December 1993 to December 2001 were retrospectively analyzed. Among them, spontaneous pneumothorax occurred in 276 patients, emphysema in 44, mediastinal tumor or cyst in 55, esophageal diseases in 78, pulmonary malignant or benign diseases in 75, and other diseases in 65. Double lumen tracheal tubes were placed in 576 patients, single one was placed to ensure one lung ventilation in 6 patients and two lung ventilation in 34 patients. surgical procedures were completed by VATS in 593 cases, and 23 cases were converted into thoracotomy because of pleural adhesion or tumor invasion. Postoperative complications occurred in 24 cases with a morbidity rate of 4 0%. Persistent air leak (over 7 days) were noted in 15 cases and postoperative bleeding in 3. One case with spontaneous pneumothorax and type Ⅱ respiratory failure died of repiratory failure on the fifth day postoperatively. Six of 276 patients with spontaneous pneumothorax relapsed. VATS has more advantages than tranditional thoracotomy for some selected chest diseases,so thoracic surgeons shoulds convert tranditional thoracotomy method to perfom VATS step by step.
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2002年第12期1107-1108,共2页
Medical Journal of Chinese People's Liberation Army
关键词
胸腔镜手术
临床应用
胸部疾病
适应证
thoracic diseases
thoracic surgery, video assisted
thoracic surgical procedures
surgical procedures, minimally invasive
