摘要
目的探讨内科胸腔镜对自发性气胸的治疗方案以减少或避免复发。方法回顾该科11例明确有肺大疱的反复发作的自发性气胸患者在局麻下施行内科胸腔镜手术,采用胸膜固定术(6例)或经胸腔镜纤维支气镜针吸活检针肺大疱内局部注入自体血及凝血酶(共4～7mL)(5例)。同时观察术中各项生命体征及血氧饱和度(SPO2)等变化情况,并随访3个月。结果术后11例患者均无呼吸困难、休克及心律失常,有2例胸痛,1例皮下气肿。术后负压闭式胸腔引流时间平均为4d,住院时间8d;随访观察3个月,无复发,无死亡。结论在内科胸腔镜直视下采用胸膜固定术或经胸腔镜纤维支气镜针吸活检针肺大疱内局部注入自体血及凝血酶的方法具有复发率低、并发症少、手术时间短、创伤小及住院时间短的优点。
【Objective】To explore the therapeutic regimen on patients with spontaneous pneumothorax by medical thoracoscopy and find out the way to reduce and avoid recurrence.【Methods】Retrospective analysis was performed on the eleven cases of patients with refractory spontaneous pneumothorax combined with lung bullaes by medical thoracoscopy in local anesthesia.Identifying location of lung bullaes on the five cases of patients by thoracoscopy,autologous fresh intravenous blood and thrombin （together 4～7 mL） was injected to lung bullae by aspiration biopsy needles of fiberoptic bronchoscopy.The six patients were adopted by pleuropexy.Simultaneously vital sign,saturation of blood oxygen were observed.The length of follow up was 3 months.【Results】11 patients after treatment were not dyspnea,shock,arhythmia.Two patients experienced chest complant,one case was compicated with cutaneous emphysema.Time of closed thoracic drainage in underpressure after operation was four days,length of stay was eight days,follow-up of 3 months,no recurrence and death occurred.【Conclusion】The advantages of those approaches for treating lung bullae by injecting autologous fresh intravenous blood and thrombin in thoracoscope include lower relapse rate,few complication,shorter operating time,less wound,and shorter hospital stay.
出处
《中国内镜杂志》
CSCD
北大核心
2010年第11期1177-1179,1183,共4页
China Journal of Endoscopy
关键词
内科胸腔镜
自发性气胸
肺大疱
medical thoracoscopy
spontaneous pneumothorax
lung Bullae
