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目的探讨胸腔镜治疗老年自发性气胸的外科手术方法。方法回顾性分析58例老年自发性气胸利用胸腔镜手术治疗的临床资料,术中选取适当的手术途径分离粘连、切除大疱及无功能的肺组织,防止肺创面漏气、促进胸膜腔粘连等措施并观察治疗效果。结果术后肺部感染6例,其中严重的肺部感染导致呼吸衰竭而死亡的1例,其余57例患者术后气胸消失,肺复张良好,患者胸闷、气急症状有所改善或消失。所有患者均治愈出院,随访时间12～18个月,无气胸复发。结论老年自发性气胸应积极采取胸腔镜手术治疗,术中详细检查肺表面,彻底切除肺大疱,防止肺创面漏气,术后促进肺复张,有效的胸腔引流等措施都是保证良好手术效果的关键。
Objective To investigate the surgical methods of thoracoscope for the treatment of elderly spontaneous pneumothorax. Methods A retrospective analysis of 58 cases of elderly spontaneous pneumothorax using thoracoscopic surgical treatment of clinical data, select the appropriate surgical approach to remove adhesions, removal of bullae and non-functional lung tissue to prevent leakage of lung wounds, and promote pleural adhesions Measure and observe the effect of treatment. Results Postoperative pulmonary infection in 6 cases, of which severe pulmonary infection led to respiratory failure and death in 1 case, the remaining 57 patients disappeared after pneumothorax, pulmonary referee well, patients with chest tightness, shortness of breath, improved or disappeared. All patients were cured and discharged, followed up for 12 to 18 months without pneumothorax. Conclusion The elderly spontaneous pneumothorax should be actively treated with thoracoscopic surgery. The detailed examination of the surface of the lung during operation, thorough resection of the bullae, prevention of air leakage in the lung wound, promotion of pulmonary recanalization after operation, and effective drainage of the thoracic cavity are all good surgical procedures The key to the effect.