腋下小切口与电视胸腔镜手术治疗自发性气胸疗效比较

目的比较腋下小切口手术(ATS)与电视胸腔镜手术(VATS)治疗自发性气胸的疗效。方法将98例自发性气胸按手术方式分为ATS组(n=63例)和VATS组(n=35例),比较两组在手术时间、术中出血量、胸管引流时间、术后住院时间、并发症的发生情况、远期自发性气胸的复发率、术后疼痛情况、手术费用和住院总费用。结果 ATS组和VATS组在手术时间、术中出血量,胸管引流时间,术后住院时间、并发症的发生情况及术后复发率方面无显著差异(P>0.05),而ATS组在术后1周的疼痛要重于VATS组。ATS组的手术费用低于VATS组。结论采用ATS组治疗自发性气胸与VATS组疗效基本相当,基层医院更适合于ATS。

A Comparative Study of the effect of Axillary thoracotomy and video-assisted thoracoscopic surgery for treatment of spontaneous pneumothorax

Objective To compare the Axillary Thoractomy Surgery(ATS) and Video-assisted thoracoscopic Surgery(VATS) for treatment of spontaneous pneumothorax,and summarize experience of two kinds of operation mode in the application of primary hospital.Methods In 2006 March to 2011 August,98 cases with spontaneous pneumothorax by operation mode is divided into ATS group(n=63) and group VATS(n=35),were compared between two groups in the operation time,intraoperative bleeding,chest tube drainage time,postoperative hospital stay,complication,long-term spontaneous pneumothorax recurrence rate,postoperative pain,operation cost and total cost of hospitalization.Results ATS group and VATS group in the operation time,bleeding volume,chest tube drainage time,postoperative hospital stay,complication and recurrence rate,no significant difference(P>0.05),while in ATS group at first week postoperative pain to focus on group VATS.Group ATS operation cost(2720+721) lower than that of group VATS(8624+786),P=0.02,ATS group of the total hospitalization expenses(9846+524) lower than that of group VATS(18523+926)P=0.01.Conclusion The treatment of spontaneous pneumothorax by group ATS and group VATS effect quite basic,but in VATS group of postoperative pain is lighter than the ATS,disadvantage is high cost,the primary hospital is more suitable for ATS,VATS is the developing direction in the future.