金素　廖平　詹会智　罗良琴　李桃萍

【摘  要】目的：对比观察胸腔镜手术与传统开胸手术治疗肺大疱的效果。方法：回顾分析了2015年1月-2019年5月在西南医科大学附属医院胸外科住院接受手术治疗的肺大疱患者524例，其中408例接受的是胸腔镜手术治疗，116例接受的是开胸手术治疗，术后均给予持续镇痛泵镇痛。比较两组患者手术时间、术中出血量、术后引流时间及量、术后住院天数及术后并发症等情况。结果：和开胸手术患者相比，胸腔镜手术组患者手术时间、术后引流时间、术后住院天数均显著缩短（P<0.05）;术后出血量、术后引流量均显著减少（P<0.01）;胸腔镜手术组患者术后肺漏气、出血、肺部感染发生率均显著降低（P<0.01）。结论：和开胸手术相比，胸腔镜手术能减轻患者痛苦、缩短住院时间和降低并发症的发生率，提高患者生活质量，值得临床推广。

【关键词】手术方式;治疗;肺大疱;效果;观察

【中图分类号】R655      【文献标识码】A      【文章编号】1004-7484（2019）06-0329-02

【Abstract】 Objective： A comparative study of the effect of thoracoscopic surgery and traditional thoracotomy in the treatment of pulmonary bullae. Method： From January 2015 to may 2019， 524 patients with pulmonary bullae were hospitalized in thoracic surgery of Southwest Medical University. 408 patients were treated with thoracoscopic surgery， 116 patients were treated with thoracotomy. All patients were given continuous analgesia pump. The operation time， intraoperative hemorrhage， postoperative drainage time and volume， postoperative hospital stay and postoperative complications were compared between the two groups. Results： Compared with patients undergoing thoracotomy， the operation time， postoperative drainage time and postoperative hospital stay in the thoracoscopic operation group were significantly shorter （P < 0.05）; the amount of postoperative bleeding and postoperative drainage flow were significantly reduced （P < 0.01）; the incidence of postoperative pulmonary air leakage， bleeding and pulmonary infection in the thoracoscopic operation group were significantly reduced （P < 0.01）.Conclusion： Compared with thoracotomy， thoracoscopic surgery can reduce the pain of patients， shorten the length of stay and reduce the incidence of complications， improve the quality of life of patients， which is worthy of clinical promotion.

【Key words】  Operative method  Treatment  Bullae of lung  Effect Observation

肺大疱是由多种原因导致肺泡腔内压力升高，肺泡壁破裂后相互融合，最后导致囊性改变，是临床上常见的一种疾病[1]。近年来，肺大疱的发病率有逐渐升高的趋势，如果患者不接受规范的治疗，一旦肺泡破裂就可引起自发性气胸。目前临床上最常用的治疗方式就是手术治疗，传统的开胸手术治疗创伤比较大，而且手术后并发症也比较多，不利于患者术后的恢复[2]。近年来，随着微创技术的不断提高，胸腔镜逐渐应用于肺大疱的治疗中。本文就傳统开胸手术方式和胸腔镜手术方式治疗肺大疱的效果展开研究，现汇报如下。……