电视胸腔镜与开胸手术治疗胸部创伤合并血气胸的比较

目的:对比开胸手术和电视胸腔镜辅助手术(VATS)对穿透性胸部创伤合并血气胸患者的治疗效果。方法:回顾性分析2016年5月—2020年5月芜湖市第五人民医院胸外科收治的112例穿透性胸部创伤合并血气胸患者,按随机数字表法将其分为微创组(62例)和开放组(50例),微创组行VATS手术治疗,开放组行开胸手术治疗,统计并对比两组患者一般资料,对比两组手术耗时、术中失血及输血量、引流量及胸管留置时间、ICU住院时间及住院总时间、术后并发症发生情况及死亡情况。结果:两组患者一般资料比较差异均无统计学意义(P>0.05);微创组手术耗时、术中失血量及输血量均低于开放组(P<0.05);微创组术后引流量少于开放组(P<0.05),微创组胸管留置时间及住院总时间短于开放组(P<0.05)。微创组术后并发症总发生率低于开放组(微创组vs开放组:13.79%vs 34.00%)(P>0.05)。结论:微创手术治疗穿透性胸部创伤合并血气胸与开放手术相比,可缩短手术耗时及总住院时间、减少术中失血与输血量、缩短胸管留置时间及减少引流量术、降低并发症的发生率。

Comparison of video-assisted thoracoscopy and thoracotomy in the treatment of thoracic trauma with hematochorax

Objective:To compare the effect of thoracotomy and video assisted thoracoscopic surgery(VATS)in the treatment of penetrating chest trauma complicated with hemopneumothorax.Methods:112 patients with penetrating chest trauma complicated with hemopneumothorax in the Department of thoracic surgery of Wuhu Fifth People's Hospital from May 2016 to may 2020 were retrospectively analyzed.They were divided into minimally invasive group(62 cases)and open group(50 cases)using random number table.VATS was performed in the minimally invasive group and thoracotomy in the open group.The general data of the two groups were counted and compared.The operation time,intraoperative blood loss and blood transfusion,drainage volume and chest tube retention time,ICU length of stay and total length of stay,the incidence of postoperative complications and death were compared between the two groups.Results:There was no significant difference in general data between the two groups(P>0.05).The operation time,intraoperative blood loss and blood transfusion in the minimally invasive group were lower than those in the open group(P<0.05).The postoperative drainage volume of the minimally invasive group was less than that of the open group(P<0.05).The chest tube indwelling time and the total hospitalization time of the minimally invasive group were shorter than those of the open group(P<0.05).The total incidence of postoperative complications in the minimally invasive group was lower than that in the open group(minimally invasive group vs open group:13.79%vs 34.00%)(P>0.05).Conclusion:Compared with open surgery,minimally invasive surgery in the treatment of penetrating thoracic trauma complicated with hemopneumothorax can shorten the operation time and total hospital stay,reduce the amount of intraoperative blood loss and blood transfusion,shorten the indwelling time of thoracic tube and reduce drainage,and reduce the incidence of complications.