west china medical publishers
Keyword
  • Title
  • Author
  • Keyword
  • Abstract
Advance search
Advance search

Search

find Keyword "自发性气胸" 31 results
  • 自发性气胸两种手术方式的对比观察

    【摘要】 目的 比较腋下小切口与常规后外侧切口手术治疗自发性气胸的临床疗效。 方法 将2006年5月-2010年1月收治的64例自发性气胸患者,按手术时间和患者自身对手术的选择性随机分为腋下小切口手术组(A组,34例)和常规后外侧切口手术组(B组,30例)。两组患者性别、年龄、单双侧、病程等一般资料比较差异无统计学意义(Pgt;0.05),具有可比性。两组均采用肺大疱切除修补术及壁层胸膜机械性摩擦。 结果 两组术后切口均Ⅰ期愈合,无切口感染等并发症发生。两组随访时间均为3~24个月,平均12.6个月;术后6个月时均无复发。A组手术时间、术中出血量、术后引流量、术后住院时间、住院费用方面均明显优于B组,差异有统计学意义(Plt;0.05)。 结论 两种手术方法均安全,但与常规后外侧切口比较,腋下小切口具有手术时间短、创伤小、恢复快、住院费用低等优点。

    Release date:2016-09-08 09:27 Export PDF Favorites Scan
  • Treatment of Spontaneous Pneumothorax

    ①在自发性气胸的治疗方面:目前尚无足够高质量的临床证据确定任何干预或非干预措施对自发性气胸的治疗更有效.现有2个小样本的随机对照试验(RCT)显示,胸腔闭式引流比穿刺抽气治疗气体消散更快,但穿刺抽气治疗更能减少患者痛苦和住院时间;1个小样本的随机对照试验显示,采用标准的胸腔闭式引流管或细管,两者的置管时间无差异,但对大量积气的患者,标准管的气体吸收率高于细管;另1个小样本的随机对照试验显示,在使用瓣膜单向阀或水封引流瓶方面,两者对患者的气胸吸收率无影响,但使用瓣膜单向阀更能减少患者痛苦和住院时间;在胸腔闭式引流管连接负压吸引方面,1个小样本的随机对照试验显示,是否连接负压吸引对疗效无影响.②在自发性气胸复发的预防方面:2个随机对照试验和1个非随机对照试验显示,化学性胸腔粘连术比非化学性胸腔粘连术更能减少自发性气胸的复发率,但胸腔粘连术同时也引起患者疼痛和住院时间的延长;无足够临床证据证明需在首次或自发性气胸复发时采用胸腔粘连术;无足够临床证据进行外科和化学性胸腔粘连术疗效的比较,仅有1个小样本的随机对照试验提示进行电视胸腔镜手术比直接开胸术的住院时间短,但在降低复发率方面,两者无显著性统计学差异,但由于样本量的问题,尚不排除两者问有临床意义差异.

    Release date:2016-09-07 02:27 Export PDF Favorites Scan
  • 剑突下入路单孔胸腔镜手术治疗自发性气胸 30 例Subxiphoid approach single-incision video-assisted thoracoscopic surgery for 30 patients with spontaneous pneumothorax

    目的 探讨剑突下入路单孔胸腔镜手术治疗自发性气胸的安全性和可行性。 方法 回顾性分析 2014 年 8 月至 2016 年 1 月间剑突下入路单孔胸腔镜手术治疗自发性气胸 30 例患者的临床资料,其中男 19 例、女 11 例,年龄 16~28(20.5±5.2)岁。 结果 手术均顺利完成,无中转开胸,无术后出血、漏气等并发症。手术时间(30.5±12.4)min,术中出血量(20.0±10.0)ml,术后胸腔引流管留置时间(1.5±0.8)d,术后住院时间(3.5±0.5)d。术后随访 1 个月,无复发、感染等其他并发症。 结论 剑突下入路单孔胸腔镜手术治疗自发性气胸安全、可行。

    Release date:2017-01-22 10:15 Export PDF Favorites Scan
  • Clinical Analysis of 48 Cases of Spontaneous Pneumothorax with Chronic Obstructive Pulmonary Disease

    目的:探讨COPD(慢性阻塞性肺病)并自发性气胸的临床特点、治疗及预后。方法:对2001年1月至2008年12月间本院收治的48例COPD并自发性气胸患者进行临床分析。结果:48例COPD并自发性气胸患者临床表现多样,首次确诊率不到80%,死亡率8.25%,单纯抽气治愈10例,胸腔闭式引流治愈22例。胸腔闭式引流+负压吸引治愈15例,手术治疗1例。肺复张平均天数单纯抽气10天, 胸腔闭式引流9天, 胸腔闭式引流+负压吸引7天, 手术治疗15天.结论:COPD并自发性气胸治疗多需排气减压术,复张时间较长,治疗以胸腔闭式引流+负压吸引为宜。

    Release date:2016-09-08 10:01 Export PDF Favorites Scan
  • Clinical Outcomes of Simultaneous Video-assisted Thoracoscopic Surgery for Bilateral Giant Bullae

    ObjectiveTo explore clinical outcomes of simutaneous video-assisted thoracoscopic surgery (VATS) for bilateral giant bullae (GB). MethodsClinical data of 160 GB patients who received surgical treatment in the First Affiliated Hospital of Xinjiang Medical University from March 2011 to April 2013 were retrospectively analyzed. According to GB location and surgical strategies, all the patients were divided into 3 groups. In group A, there were 108 patients with spontaneous pneumothorax (SP) and unilateral GB who underwent unilateral GB resection with VATS, including 88 male and 20 female patients with their age of 31.36±16.14 years. In group B, there were 40 patients with SP and bilateral GB who underwent unilateral GB resection in the SP side with VATS, including 36 male and 4 female patients with their age of 37.63±18.84 years. In group C, there were 12 patients with SP and bilateral GB who underwent simultaneous bilateral GB resection with VATS, including 9 male and 3 female patients with their age of 32.58±16.06 years. Postoperative morbidity and SP recurrence rates were analyzed. ResultsAll the operations were successfully performed, and patients were followed up for 20 months after discharge. In group A, postoperative complications included acute pulmonary edema in 1 patient, pleural adhesion in 11 patients, respiratory failure in 2 patients, and pulmonary air leak in 5 patients. During follow-up, SP recurred in 5 patients including 2 patients with SP recurrence at the same side and 3 patients with SP recurrence at the other side of thorax. In group B, postoperative complications included pleural adhesion in 4 patients, respiratory failure in 1 patient, and pulmonary air leak in 3 patients. During follow-up, SP recurred in 18 patients including 3 patients with SP recurrence at the same side and 15 patients with SP recurrence at the other side of thorax. In group C, postoperative complications included pleural adhesion in 2 patients and pulmonary air leak in 1 patient. During follow-up, SP recurred in 1 patient at the same side of thorax. SP recurrence rates of group A and C were significantly lower than that of group B (P=0.000 and P=0.031 respectively). ConclusionSimultaneous VATS is safe, efficacious and reliable for the treatment of bilateral GB, and can effectively prevent SP recurrence at the other side of thorax.

    Release date:2016-10-02 04:56 Export PDF Favorites Scan
  • Current status of video-assisted thoracoscopic surgery for spontaneous pneumothorax

    Surgical treatment is an important treatment for spontaneous pneumothorax, which can remove the gas in the pleural cavity, relieve symptoms, promote lung recruitment, moreover, prevent future recurrence. The surgical modalities included video-assisted thoracoscopic surgery (VATS) and non VATS treatment. Nowadays, the treatment of spontaneous pneumothorax has entered a minimally invasive era. With the development of minimally invasive techniques in recent years, as the representative of minimally invasive surgery, the surgeon techniques of VATS has developed to diversity, including three-port VATS, two-port VATS, uniportal VATS, subxiphoid uniportal VATS, 3D VATS, robotic-assisted VAT and cervical uniportal VATS. Each technique has its own advantages and limitations, and individual choices should be made.

    Release date:2018-07-27 02:40 Export PDF Favorites Scan
  • Treatment plan and clinical effect of the first primary spontaneous pneumothorax in young patients

    ObjectiveTo investigate the optimal treatment scheme for the first primary spontaneous pneumothorax (PSP) in young patients.MethodsThe clinical data of 171 patients with the first PSP were retrospectively analyzed who were treated in Huaihe Hospital of Henan University between November 2011 and October 2017. There were 157 males and 14 females with a median age of 18 years at onset and a median body mass index of 18.51 kg/m2. According to the treatment methods, they were classified into two groups, a conservative treatment group (a non-surgical group, n=86) and a surgical group (n=85). The characteristics including clinical data, efficacy evaluation criteria, complications and recurrence of the two groups were analyzed.ResultsAs a result, 73.68% of the patients suffered PSP in their daily routine. The drainage duration in the non-surgical group was longer than that in the surgical group (4 d vs. 3 d, P=0.008). There was no statistical difference in the success rate of lung re-expansion between the two groups (98.85% vs. 100.00%, P=1.000). The proportion of the surgical group using postoperative analgesic drugs was higher than that in the non-surgical group (48.23% vs. 10.46%, P=0.000). The recurrence rate of the surgical group was lower than that of the non-surgical group (3.53% vs. 46.51%, P=0.000). No relationship between smoking and recurrence of pneumothorax was found in both groups (P=0.301, P=1.000). The success rate of lung re-expansion in the non-surgical group was not statistically different between the 24F subgroup and the 12F subgroup (39/39 vs. 33/34, P=0.458). No advantage of intraoperative pleural fixation was found in the surgical group (P=0.693).ConclusionThoracoscopic surgery is the first choice for the treatment of the first PSP in young patients.

    Release date:2021-07-28 10:22 Export PDF Favorites Scan
  • 高渗葡萄糖胸膜固定治疗自发性气胸

    自发性气胸是临床常见急症之一,其治疗原则是排出胸腔内的气体,促进肺脏层胸膜裂口愈合,预防气胸复发[1]。作者科室应用高渗葡萄糖胸膜固定治疗自发性气胸68例,取得满意的疗效。现报告如下。

    Release date:2016-09-14 11:56 Export PDF Favorites Scan
  • A Clinical Study of Spontaneous Pneumothorax in Elderly Patients

    目的:探讨老年人自发性气胸的临床特点、治疗及预后。方法:对本院在2005年11月至2008年4月间收治的79例老年人自发性气胸患者临床资料进行回顾性分析。结果:老年人自发性气胸大多有肺部基础疾病,临床表现缺乏特异性,本组误诊为慢性阻塞性肺病急性发作4例、左心衰2例、支气管哮喘1例。气胸类型: 张力性气胸47例(72.1%),闭合性气胸11例,交通性气胸21例。采用以肋间闭式引流的为主的治疗措施,效果好。结论:老年人自发性气胸大多有肺部基础疾病, 易误诊,气胸的类型以张力性气胸多见,治疗多需排气减压术,及早的排气减压可望缓解症状,缩短肺复张时间,减少患者住院天数, 降低死亡率,提高老年人生活质量。

    Release date:2016-09-08 10:00 Export PDF Favorites Scan
  • Efficacy and safety of single-port, two-port, and three-port video-assisted thoracoscopic surgery in the treatment of spontaneous pneumothorax: A systematic review and meta-analysis

    Objective To systematically evaluate the efficacy and safety of Single-incision thoracoscopic surgery (SITS) and two-port video-assisted thoracoscopic surgery (2P-VATS) in the treatment of spontaneous pneumothorax. Methods The databases of CNKI, PubMed, The Cochrane Libray, Web of Science, EMbase, Wanfang and Chinese Medical Association were searched by computer. Literature on SITS treatment of spontaneous pneumothorax from the establishment of the database to March 2023. The data are processed with RevMan 5.4.1. Results Finally, 107 studies were included, including 35 RCTs, 2 cohort studies, and 70 case-control studies. Meta analysis results show that compared to 2P-VATS and three port video assisted thoracoscopic surgery (3P-VATS), SITS had a shorter surgical time [SMD=–0.53, 95%CI (–0.90, –0.16), P=0.005], less intraoperative bleeding [SMD=–1.58, 95%CI (–1.93, –1.22), P<0.000 01; SMD=–1.59, 95%CI (–2.03,–1.14), P<0.000 01], shorter postoperative hospitalization time [SMD=–1.05, 95%CI (–1.29,–0.82), P<0.000 01; SMD=–1.08, 95%CI (–1.39,–0.77), P<0.000 01], and shorter postoperative drainage (catheterization) time [SMD=–0.75, 95%CI (–1.00,–0.50), P<0.000 01; SMD=–1.23, 95%CI (–1.72,–0.75), P<0.000 01], fewer postoperative complications [OR=0.34, 95%CI (0.26,0.45), P<0.000 01; OR=0.47, 95%CI (0.33,0.68), P<0.000 1], fewer postoperative recurrences [OR=0.50, 95%CI (0.33,0.75), P=0.000 8], and lighter postoperative pain [SMD=–1.71, 95%CI (–1.98,–1.45), P<0.000 01; SMD=–2.02, 95%CI (–2.46,–1.59), P<0.000 01]. Compared with 3P-VATS, 2P-VATS had less intraoperative bleeding [SMD=–1.02, 95%CI (–1.81,–0.22), P=0.01] , shorter postoperative hospitalization time [SMD=–0.59, 95%CI (–1.11,–0.06), P=0.03], shorter postoperative drainage (catheterization) time [SMD=–0.46, 95%CI (–0.85,–0.08), P=0.02], fewer postoperative complications [OR=0.36, 95%CI (0.22,0.59), P<0.000 1] , and lighter postoperative pain [SMD=–0.80, 95%CI (–1.08,–0.53), P<0.000 01]. Conclusion SITS and 2P-VATS are an effective and safe method for the treatment of spontaneous pneumothorax and worthy of further promotion and application in clinical practice. Due to limitations in the quantity and quality of included studies, the above conclusions require more large-sample, high-quality studies to be verified.

    Release date: Export PDF Favorites Scan
4 pages Previous 1 2 3 4 Next

Format

Content