黄健文　龙志华　陈国海　陈海军　张明

【摘要】 目的：探讨自发性气胸患者单操作孔胸腔镜手术治疗的有效性及对手术时间、出血量的影响。方法：选取2012年1月-2020年10月本院收治的50例自发性气胸患者，依据手术方式的不同分为对照组和研究组，各25例。对照组采用三孔胸腔镜治疗，研究组采用单操作孔胸腔镜手术治疗。对比两组临床指标状况、术后疼痛评分及并发症发生情况。结果：研究组手术时间、呼吸机应用时间、住院时间均比对照组短，术中引流量、术中出血量均少于对照组，差异均有统计学意义（P<0.05）。术后12、24、48 h，研究组疼痛评分均低于对照组（P<0.05）。研究组并发症发生率为12.0%，低于对照组的36.0%，差异有统计学意义（P<0.05）。结论：应用单操作孔胸腔镜手术治疗自发性气胸具有显著优势，可缩短患者手术时间，降低出血量，减少住院时间，利于早期康复，还能有效减轻患者术后疼痛，降低术后并发症发生率，值得借鉴。

【关键词】 自发性气胸 单操作孔 胸腔镜手术 手术时间 出血量

[Abstract] Objective： To investigate the effectiveness of single port thoracoscopic surgery for spontaneous pneumothorax and its influence on operation time and blood loss. Method： A total of 50 patients with spontaneous pneumothorax admitted to our hospital from January 2012 to October 2020 were selected， they were divided into control group and study group according to different surgical methods， 25 cases in each group. The control group was treated with three hole thoracoscopy， the study group was treated with single operation hole thoracoscopy. Clinical indicators， postoperative pain scores and complications were compared between two groups. Result： The operative time， ventilator application time and hospital stay in the study group were shorter than those in the control group， the amount of intraoperative drainage and intraoperative blood loss in the study group were lower than those in the control group， the differences were statistical significance （P<0.05）. The pain scores of the study group were lower than those of the control group at 12， 24 and 48 h after surgery （P<0.05）. The complication rate in the study group was 12.0%， which was lower than 36.0% in the control group ， the difference was statistically significant （P<0.05）. Conclusion： The application of single port thoracoscopic surgery in the treatment of spontaneous pneumothorax has significant advantages， can shorten the operation time， reduce the amount of bleeding， reduce the length of hospital stay， conducive to early rehabilitation， but also can effectively reduce the degree of postoperative pain， reduce the probability of postoperative complications， which is worthy of reference.

[Key words] Spontaneous pneumothorax Single port Thoracoscopic surgery Operation time Blood loss

First-authors address： Luoding City Peoples Hospital， Luoding 527200， China

doi：10.3969/j.issn.1674-4985.2021.09.014

自發性气胸属于临床较为常见病症，该病是由多原因引起的慢性病理状态，中青年男性是该病的主要发病群体，自发性气胸的主要诱发因素是肺组织破裂或者脏层胸膜破裂等，导致肺部与支气管处的空气进入胸膜腔，形成气胸[1-2]。临床症状主要表现为不同程度的胸部疼痛、咳嗽、呼吸不顺畅等情况，须及时干预。患者若得不到及时治疗会形成肺大疱，使胸痛、气短症状加重，威胁患者生命安全[3]。所以，针对自发性气胸应开展合理、正确的治疗干预。针对该病临床多以胸腔闭式引流、胸腔穿刺抽气等治疗，由于患者多伴有肺大疱形成，疗效不显著，所以多以手术切除治疗[4]。兴起于20世纪80年代的胸腔镜微创手术已成为当前自发性气胸的首选治疗方案[5]。胸腔镜微创术操作主要有三孔法、单操作孔法及单孔法，相关研究指出，单操作孔法及单孔法术后疼痛程度小于三孔法，对此，本研究对患者应用单操作孔胸腔镜手术治疗，并将其有效性及对临床指标的影响进行以下探究，现进行报道如下。……