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目的 :比较与分析胸腔镜与常规开胸术治疗肺大疱临床疗效及安全性。方法 :82例拟手术肺大疱患者按照随机抽签法分为对照组与观察组各41例。对照组采用常规开胸术治疗;观察组采用胸腔镜术治疗。比较两组患者术中出血量、手术时间、止痛时间、止痛药物用量、住院费用、住院时间、术后24h引流量、引流管拔出时间、并发症、随访1年复发率。结果 :观察组术中出血量和手术时间及止痛时间及止痛药物使用量分别为(67.52±10.56)m L、(75.42±12.71)min、(4.26±2.75)d、(785±287)mg/d与对照组(146.10±14.95)m L、(98.61±16.24)min、(6.79±2.79)d、(1002±302)mg/d比较(P<0.05)。两组患者住院时间、住院费用、术后24h引流量、引流管拔出时间比较;观察组并发症率及1年内复发率分别为2.44%(1/41)、4.88%(2/41)明显低于对照组14.63%(6/41)、17.07%(7/41)。结论 :肺大疱患者采用胸腔镜术治疗手术时间短,术中出血量少,术后恢复快,复发率低,值得推广应用。
Objective: To compare and analyze the clinical efficacy and safety of thoracoscope and routine thoracotomy in the treatment of bullous bullae. Methods: 82 cases of patients with pulmonary bullae were randomly divided into control group and observation group, 41 cases in each group. The control group was treated by conventional thoracotomy. The observation group was treated by thoracoscope. The bleeding volume, operation time, analgesic time, analgesic dosage, hospitalization cost, hospitalization time, drainage volume after 24 h, drainage time of drainage tube, complication and follow-up of 1 year follow-up were compared between the two groups. Results: The intraoperative blood loss, operation time, analgesic time and analgesic doses in the observation group were (67.52 ± 10.56) m L, (75.42 ± 12.71) min, (4.26 ± 2.75) d and (785 ± 287) mg / d compared with the control group (146.10 ± 14.95) m L, (98.61 ± 16.24) min, (6.79 ± 2.79) d and (1002 ± 302) mg / d respectively (P <0.05). The hospitalization time, hospitalization cost, drainage volume after 24 hours and drainage time of drainage tube were compared between two groups. The complication rate and recurrence rate within one year were 2.44% (1/41) and 4.88% (2/41) respectively in the observation group 14.63% (6/41) and 17.07% (7/41) lower than the control group. Conclusions: Thoracoscopic surgery in patients with pulmonary bullae has the advantages of short operative time, less intraoperative blood loss, quick recovery after operation, and low recurrence rate, which is worth popularizing and applying.