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目的：对比观察电视胸腔镜手术（video-assisted thoracospic surgery，VATS）与传统开胸手术在小儿肺叶切除术中的临床效果。方法2012年6月至2015年12月本院共收治61例需行肺叶切除的患儿，依照患儿病变情况及家属意愿分别采取了电视胸腔镜手术（VATS 组）和开胸手术（开胸组）。VATS 组22例中，14例在电视胸腔镜辅助下行小切口肺叶切除术，8例在全胸腔镜下行肺叶切除术；开胸组39例接受传统开胸肺叶切除术。比较两组手术切口、手术时间、术中出血量、输血比例、术后使用呼吸机时间、引流量多于2 mL·kg －1·d －1的天数、术后重症监护室滞留时间、术后并发症的发生率，以及围手术期白细胞、C 反应蛋白、降钙素原等指标。结果两组均顺利完成手术，无死亡及严重并发症。两组年龄、体重、发病部位以及病理改变无显著性差异（P ＞0.05）；术后并发症的发生率无显著性差异（P ＞0.05）；与传统开胸组相比，VATS 组切口长度（2.87±1.04 cm vs 8.25±2.32 cm，t ＝－2.741， P ＝0.003）、手术时间（85.67±23.95 minuts vs 110.48±32.71 minuts，t ＝－3.112，P ＝0.002）、术中出血量（80.00±45.40 mL vs 143.04±67.04 mL，t ＝－4.112，P ＝0.002）、输血比例（P ＝0.043）、引流量大于2 mL·kg －1·d －1的天数（3.66±1.74 d vs 6.26±3.59 d，t ＝－4.305，P ＝0.000）、术后重症监护室滞留时间大于24 h、呼吸机辅助通气时间大于12 h 的例数均降低（P ＜0.05）；术后第1 d 胸腔镜组中白细胞（5.68±1.59×109／L vs 13.99±1.74×109／L，t ＝－4.325，P ＝0.002）、CRP（16.68±2.55 mg／L vs 25.63±4.67 mg／L，t ＝－6.613，P ＝0.000）以及 PCT（1.40±0.61 ng／mL vs 6.61±3.17 ng／mL，t ＝－7.372，P＝0.002），均低于传统开胸组（P ＜0.05）。结论与传统开胸组相比，VATS 下行小儿肺叶切除术出血少，术后呼吸机使用时间、ICU 滞留时间短，应激性炎症反应弱，但对于降低并发症的发生率并无显著差异。“,”Objetive To compare the different clinical value of video-assisted thoracoscope surgery (VATS ) and the conventional thoracotomy lobectomy in infants and yong children via observa-tion. Methods Pulmonary lobectomies were carried on a total of 61 cases from June 2012 to December 2015.VATS lobectomy (VATS group)was carried on 22 cases,including video-assisted mini-thoracotomy lobectomy on 14 cases,and full thoracoscopic lobectomy on 8 cases.Conventional thoractomy (conventional group)was carried on 39 cases.The incision length,operation time,intraoperative bleeding volume,rate of blood transfu-sion,time for using breathing machine after operation,number of days for chest drainage volume greater than 2 mL·/kg -1 ·d -1 ,time for staying in ICU,incidence of complications,and the changes of white blood cells, C-reactive protein and serum procalcitonin during peri-operation. Results No severe complication and opera-tive death was recorded.There was no significant difference on ages,body weight,sites,pathological changes, and incidence of complications between VATS group and conventional thoracotomy group (P >0.05).There was statistical significance between VATS group and conventional thoracotomy group in incision length(2.87 ± 1.04 cm vs 8.25 ±2.32 cm ,t =-2.741,P =0.003),operation time(85.67 ±23.95 minutes vs 110.48 ± 32.71 minutes,t =-3.112,P =0.002),intraoperative bleeding volume(80.00 ±45.40 mL vs 143.04 ±67.04 mL,t =-4.112,P =0.002),rate of blood transfusion was observed(P =0.043),number of days for chest drainage volume greater than 2 ml/kg·d(3.66 ±1.74 d vs 6.26 ±3.59 d,t =-4.305,P =0.000).In VATS group,number of cases with breathing machine after operation for more than 12 h,and cases in ICU time for more than 24 h were reduced in comparison with those in conventional thoracotomy group (P <0.05).The levels of white blood cell (5.68 ±1.59 ×109 /L vs 13.99 ±1.74 ×109 /L,t =-4.325,P =0.002),CRP (16.68 ±2.55 mg/L vs 25.63 ±4.67 mg/L,t =-6.613,P =0.000)and PCT(1.40 ±0.61 ng/mL vs 6.61 ±3.17 ng/mL,t =-7.372,P =0.002)in VATS group were significantly lower than that in conventional thora-cotomy group. Conclusions Compared with the conventional thoracotomy group,VATS group has characteris-tics of lower intraoperative bleeding volume,shorter time for using a ventilator and for duration in ICU,decreased postoperative irritability inflammation,and no significant difference in reducing the incidence of complications.