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《Chinese Journal of Difficult and Complicated Cases》 2017-03
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Clinical efficacy and changes of pulmonary function in elderly patients with spontaneous pneumothorax treatment with thoracoscopic surgery

HU Jian;TANG Xingsong;ZHOU Bo;WU Bo;HE Mingxue;Department of Thoracic Surgery;Dazhou Hospital of Integrated Traditional Chinese and Western Medicine;  
Objective To investigate the therapeutic effect of video-assisted thoracoscopic surgery(VATS) in the treatment of refractory spontaneous pneumothorax in elderly patients.Methods From March 2013 to March 2016,84 cases of elderly patients with refractory spontaneous pneumothorax were selected as the research object,which were randomly divided into the control group(n = 42) and the observation group(n = 42).The 2 groups of patients underwent double lumen endotracheal intubation and general anesthesia,contralateral decubitus.The control group was treated with traditional thoracotomy,while the observation group was treated with thoracoscopy.The clinical efficacy,peri operation and pulmonary function indexes were compared between the 2 groups,and the adverse reactions were recorded in the 2 groups.Results The total efficiency of the observation group(97.6%) was significantly higher than that of control group(85.7%),the difference was statistically significant(x~2=3.896,P =0.048);the observation group incision length,operative time,intraoperative bleeding volume,postoperative drainage volume,postoperative drainage time,extubation time,hospitalization time were significantly lower than the control group,the differences were statistically significant(t=21.280,t =31.806,t=30.301,t =9.127,t=6.469,t = 14.277,t =7.502,P 0.01);postoperative observation groups FEV_1,FVC and MVV were significantly higher than the control group,RV was significantly lower than the control group(t =9.418,t= 11.665,t =7.260,t =3.767,P 0.01);persistent pulmonary air leakage,postoperative bleeding,pulmonary or pleural effusion the infection or atelectasis,pneumothorax recurrence of symptoms were significantly lower than the control group after operation in the 2 groups(x~2=4.504,x~2=5.224,x~2=6.797,x~2=4.504,P 0.05),and reexpansion pulmonary edema occurred,no difference statistical significance(x~2=0.378,P 0.05).Conclusion Thoracoscopic surgery in the treatment of refractory spontaneous pneumothorax in elderly patients can effectively improve lung function,and fast recovery,good safely,worthy of clinical application.
【CateGory Index】: R655
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