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目的:探讨并比较胸腔镜下单孔、双孔及三孔操作切除肺大疱手术效果。方法:选取2012年6月~2014年6月医院收治的73例择期电视胸腔镜(VATS)下肺大疱手术患者作为研究对象,根据操作孔数分为单孔组(n=22)、双孔组(n=23)、三孔组(n=28)。记录三组手术时间、术中出血量、切口长度、引流管留置时间、术后引流量、住院时间及术后并发症;术后1d、术后5d均发放疼痛视觉评分量表(VAS)评估疼痛程度,检测一秒用力呼气量(FEV1)、FEV1占预计值百分比(FEV1%)、用力肺活量(FVC)、每分钟最大通气量(MVV)。术后门诊和电话随访1年,记录两组疾病复发率、气胸发生率。结果:三组患者手术时间、术中出血量、引流管留置时间、住院时间比较无明显差异。三组患者术前、术后肺功能比较无差异。三组术后术后并发症率、1年后复发率及1年气胸发生率无明显差异;单孔组切口长度短于双孔组、三孔组,双孔组、三孔组组间比较无差异;单孔组术后1d、5d VAS评分明显高于双孔组、三孔组,双孔组、三孔组组间比较有差异。结论:胸腔镜下单孔、双孔及三孔操作切除肺大疱手术效果基本一致,但单孔操作孔手术切口短,术后疼痛程度轻。
Objective: To investigate and compare thoracoscopic single hole, double hole and three hole operation of lung bullae operation effect. Methods: Seventy-three patients undergoing VATS with bullae undergoing surgery from June 2012 to June 2014 were selected as study subjects. The number of operation holes was divided into single hole group (n = 22) and double Well group (n = 23), triple-well group (n = 28). The operation time, intraoperative blood loss, incision length, drainage tube indwelling time, postoperative drainage, hospitalization time and postoperative complications were recorded. VAS score was assessed on the first day and the fifth day after operation Pain, FEV 1, FEV 1%, FVC and MVV. Postoperative clinic and telephone follow-up of 1 year, record the two groups of disease recurrence rate, pneumothorax incidence. Results: The operation time, intraoperative blood loss, drainage tube indwelling time and hospital stay in three groups showed no significant difference. Three groups of patients before and after surgery no difference in lung function. There were no significant differences in the postoperative complication rate, recurrence rate after 1 year and pneumothorax incidence at 1 year in the three groups. The incision length in the single hole group was shorter than that in the double hole group, the triple hole group, the double hole group and the triple hole group There was no difference between the two groups. The VAS score of the one-hole group was significantly higher than that of the two-hole group on the 1st day and the 5th day after the operation. The three-hole group, the two-hole group and the three-hole group were significantly different. Conclusions: The effect of single hole, double hole and three holes operation under thoracoscopic surgery is basically the same, but the single hole operation hole is short and the degree of postoperative pain is light.