全电视胸腔镜与开胸肺叶切除术比较的病例对照研究

目的 比较全电视胸腔镜手术（VATS）与开胸手术对肺叶切除的疗效.方法 采用病例对照研究的方法,收集江苏省宜兴市人民医院2010年5月～2013年5月行VATS肺叶切除术患者32例（观察组）,收集同期行开胸肺叶切除术患者32例为对照组.比较患者手术时间、手术出血量、术后胸腔积液、胸引管带管时间、住院时间等;采用Logas疼痛评分法对患者的疼痛进行评分;比较两组并发症发生情况.结果 ①两组手术时间差异无统计学意义（P＞0.05）;两组患者手术出血量[（138.24±38.37）mL比（175.62±30.66）mL]、术后胸腔积液[（1058.80±259.68）mL比（1458.32±297.19）mL]、胸引管带管时间[（5.6±1.8）d比（7.2±1.5）d]、切口疼痛评分[（5.8±1.6）分比（7.5±1.8）分]、术后住院时间[（6.3±1.5）d比（7.6±1.9）d]等指标差异均有统计学意义（P＜0.05）.②两组漏气＞1周、咯血＞1周、皮下气肿、肺部感染等单项术后并发症差异无统计学意义（P＞ 0.05）;观察组术后并发症合计发生率[12.50％（4/32）]低于对照组[25.00％ （9/32）],差异有统计学意义（x2=3.721,P=0.049）.结论 VATS用于肺叶切除患者,安全有效,并发症少,值得临床应用.

Case control study of video-assisted thoracoscopic pulmonary lobectomy surgery and thoracotomy pulmonary lobectomy

Objective To compare the curative effect of pulmonary lobectomy by video-assisted thoracoscopic surgery and thoracotomy.Methods 32 patients of VATS pulmonary lobectomy （observation group） and 32 cases of thoracotomy pulmonary lobectomy （control group） in the People＇s Hospital of Yixing City from May 2010 to May 2013 were selected according to case control study.Operation time,operation bleeding,postoperative pleural effusion,intrathoracic drain tube time,postoperative hospital stays of the two groups were compared; the pain score were evaluated by Logas scoring method; complications of the two groups were compared.Results ①The difference of operation time in the two groups was not statistically significant （P ＞0.05）.The differences of operation bleeding [（138.24±38.37） mL vs （175.62±30.66） mL],postoperative pleural effusion [（1058.80±259.68） mL vs （1458.32±297.19） mL],intrathoracic drain tube time [（5.6±1.8） days vs （7.2±1.5） days],incision pain score [（5.8±1.6） pionts vs （7.5±1.8） points],postoperative hospital stays [（6.3±1.5） days vs （7.6±1.9） daye] in the two groups were statistically significant （P ＜ 0.05）.②The differences postoperative complications of air leakage＞ 1 week,hemoptysis ＞ 1week,pneumoderm,pulmonary infection in the two groups was not statistically significant （P ＞ 0.05）; the total complications occurrence rate in observation group [12.50％ （4/32）] was lower than that in control group [25.00％ （9/32）],the differences were statistically significant （x2 =3.721,P =0.049）.Conclusion The VATS lobectomy is safe,effective and has fewer complications,it is worthy to apply in the clinical surgery.