【摘要】 目的探讨全胸腔镜与开胸手术治疗孤立性肺小结节的疗效。方法回顾性分析我院2014年1月～2016年6月手术治疗的100例孤立性肺小结节患者,按照手术方式分为开胸组和VATS组,各50例。开胸组采用传统开胸手术治疗,VATS组采用全胸腔镜手术治疗。比较两组患者的手术时间、术中出血、术后当日引流量、术后拔引流管时间、镇痛时间和住院时间。结果两组患者生存率、病理性质比较,差异无统计学意义(P>0.05)。与开胸组比较,VATS组手术时间短[(114.3±29.5)min vs(151.2±47.3)min],术中出血少[(41.5±12.9)ml vs(145.1±65.8)ml],术后当日引流量少[(150.2±46.3)ml vs(220.1±55.4)ml],镇痛时间短[(2.2±1.3)d vs(7.5±1.6)d],术后拔引流管时间短[(2.2±1.3)d vs(5.8±2.6)d],术后住院时间短[(8.1±2.1)d vs(14.1±1.8)d],差异具有统计学意义(P<0.05)。术后发生肺部感染、肺不张、心律失常VATS组分别为1例、1例、0例,开胸组为3例、2例、1例,两组差异无统计学意义(P>0.05)。结论全胸腔镜手术治疗孤立性肺小结节比开胸手术创伤小、术中出血少、手术时间短、疼痛轻、术后恢复快、并发症少,适合在临床基层医院开展应用。更多还原

【Abstract】 Objective To investigate the efficacy of total thoracoscopic and thoracotomy in the treatment of solitary pulmonary nodules.Methods A retrospective analysis of 100 patients with solitary pulmonary nodules from January 2014 to June 2016 in our hospital was divided into open chest group and VATS group according to the surgical method,50 cases each.The open chest group was treated with conventional thoracotomy,and the VATS group was treated with total thoracoscopic surgery.The operation time,intraoperative bleeding,day-to-day drainage,postoperative drainage time,analgesia time,and length of hospital stay were compared between the two groups.Results There was no significant difference in the survival rate and pathological properties between the two groups(P>0.05).Compared with the open chest group,the operative time of the VATS group was shorter [(114.3 ±29.5)min vs(151.2 ±47.3)min],and intraoperative bleeding was less[(41.5 ±12.9)ml vs(145.1 ±65.8)ml],the day after surgery less drainage[(150.2 ±46.3)ml vs(220.1 ±55.4)ml],short analgesia time [(2.2±1.3)d vs(7.5±1.6)d],postoperative drainage tube time is short [(2.2 ±1.3)d vs(5.8±2.6)d],postoperative hospital stay was short[(8.1±2.1)d vs(14.1±1.8)d],the difference was statistically significant(P<0.05).Postoperative pulmonary infection,atelectasis,and arrhythmia in the VATS group were 1 case,1 case,and 0 case,and the open chest group was 3 cases,2 cases,and 1 case.There was no significant difference between the two groups(P>0.05).Conclusion Total thoracoscopic surgery for solitary pulmonary nodules has the advantages of less trauma,less bleeding,shorter operation time,less pain,faster postoperative recovery and fewer complications than thoracotomy.It is suitable for clinical grass-roots hospitals.更多还原