摘要
目的:研究胸腔镜辅助下膈疝修补术的安全性及有效性,指导胸腔镜临床应用的广泛开展。方法:回顾性分析收住我科并行胸腔镜辅助下膈疝修补术的患者37例,其中食管裂孔疝9例,胸腹裂孔疝6例,创伤性膈疝14例,新生儿先天性膈疝8例,同时对比未采用胸腔镜辅助下手术治疗的膈疝患者33例,分析胸腔镜辅助下手术治疗的效果,评估安全性及临床应用价值,对比其与传统开放式手术的疗效差异。结果:胸腔镜辅助下膈疝修补术患者的平均手术时间、平均术中出血量均小于开放式手术患者(P<0.05);实验组患者术后置管时间短,平均住院时间短,并发生发生率、膈疝复发率及先天性膈疝患儿的手术死亡率均低于对照组(P<0.05)。结论:胸腔镜辅助下的膈疝修补术应用广泛,安全性较高,创伤小、并发症少,但是应用于严重创伤导致的膈疝患者有一定的局限性,在符合临床适应证的情况下,应尽量选择胸腔镜治疗,但不能盲目应用。
Objective:To explore the security and efficiency of thoracoscopy-assisted surgeries in diaphragmatic hernia suture,which will help to guide the extensive clinical application.Methods:Patients with diaphragmatic hernia who received thoracoscopy-assisted surgeries or open surgeries were analyzed retrospectively,the treatment outcome of two groups were compared.Results:The mean operation time,mean bleeding volume of thoracoscopy-assisted surgery group were less than that of open surgery group(P<0.05);the time of indwelling catheter,mean hospital stays,complication rate,recurrence rate and mortality rate in thoracoscopy-assisted surgery group were less than that of open surgery group(P<0.05).Conclusion:Thoracoscopy-assisted surgeries in diaphragmatic hernia suture were widely accepted and applied,as its high security,small wound and minimum complication,thoracoscopy-assisted surgeries should be used more extensively.However in serious trauma induced diaphragmatic hernia,thoracoscopy-assisted surgeries have its limitation.
作者
薛锋
廖和和
王鹏国
郭小琦
王博
余明
李俊海
Xue Feng;Liao Hehe;Wang Pengguo(No.215 Hospital of Shaanxi Nuclear Industry,Xianyang 712000)
出处
《陕西医学杂志》
CAS
2018年第2期199-201,205,共4页
Shaanxi Medical Journal
基金
陕西省社会发展科技攻关项目(2015SF239)
