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目的:观察胸腔镜(VATS)下单肺叶切除对西宁地区肺疾患患者肺功能的影响。方法:以2013年10月—2016年4月在我院接受治疗的需行单肺叶切除术的患者为观察对象,根据其手术方式分为传统开胸肺叶切除术组(常规手术组)和胸腔镜微创肺叶切除术组(胸腔镜组)。观察两组患者非吸氧状态下第(1~3)天及第7天PaO_2变化,术后1月肺功能检查结果(VC、FVC、FEV1及MVV),以及术后肺部感染、肺栓塞及肺不张等呼吸系统并发症发生率,并进行统计学处理,比较两组患者术前术后肺功能差异。结果:两组患者术后PaO_2及肺功能指标较术前均明显降低,胸腔镜组PaO_2及肺功能指标术后优于常规手术组,呼吸系统并发症发生率较常规手术组低。结论:肺疾患需行单肺叶切除的术式选择中,全胸腔镜术式较传统开胸术式对患者术后早期肺功能影响小,更适合于高原低氧环境下肺疾患患者的手术治疗。
Objective: To observe the effect of single lobectomy with thoracoscope (VATS) on pulmonary function in patients with lung disease in Xining area. Methods: Patients undergoing single lobectomy who underwent treatment in our hospital from October 2013 to April 2016 were divided into two groups: conventional open-chest lobectomy group (conventional operation group) and thoracic cavity Microscopic minimally invasive lobectomy group (thoracoscopic group). The changes of PaO_2, the results of pulmonary function examination at 1 month after operation (VC, FVC, FEV1 and MVV) and the postoperative pulmonary infection, pulmonary embolism And atelectasis and other respiratory complications, and statistical analysis, comparison of two groups of patients before and after pulmonary function differences. Results: The postoperative PaO_2 and pulmonary function indexes of the two groups were significantly lower than those before operation. PaO_2 and pulmonary function indexes of thoracoscopic surgery group were better than those of conventional surgery group. The incidence of respiratory complications was lower than that of conventional surgery group. CONCLUSIONS: Thoracoscopic surgery is more effective than early thoracotomy for early postoperative pulmonary function in patients with lung disease due to single lobectomy. It is more suitable for surgical treatment of patients with lung disease under high altitude hypoxia .