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目的探讨全胸腔镜肺叶切除术中转开胸手术指征,为及时正确判断患者是否需要中转开胸治疗提供可靠临床依据,保障患者预后及生命安全。方法 21例肺部疾病患者均采取全胸腔镜肺叶切除术治疗,且手术过程中均发生中转开胸手术,记录患者中转开胸原因,进行统计学分析后得出结论。结果 33例全胸腔镜肺叶切除术患者中转开胸原因包括血管损伤、淋巴结干扰、粘连等,其中肺动脉损伤所占比例最高,为24.24%,对比结果具有统计学意义(P<0.05)。结论临床医师应根据肺部疾病患者实际情况选择手术治疗方案。全胸腔镜肺叶切除术患者术中若发生血管损伤、淋巴结干扰、严重粘连无法分离、患者不耐受等情况应及时改用中转开胸手术治疗,以免出现严重后果威胁患者生命安全。
Objective To investigate the indications of thoracoscopic lobectomy for thoracotomy and to provide a reliable clinical basis for timely and correctly judging whether the patients need transit thoracotomy or not and to ensure the prognosis and life safety of patients. Methods Twenty - one patients with pulmonary diseases were treated by thoracoscopic lobectomy. Transcatheter thoracotomy was performed during the operation. The reasons of the patients’ conversion to thoracotomy were recorded and the results were statistically analyzed. Results Thirty - three cases of thoracoscopic lobectomy were involved in the reasons of thoracotomy, including vascular injury, lymph node interference and adhesions. Among them, pulmonary injury accounted for the highest proportion (24.24%), with statistical significance (P <0.05). Conclusion Clinicians should choose surgical treatment plan according to the actual conditions of patients with pulmonary disease. Thoracoscopic lobectomy in patients with vascular injury, lymph node interference, severe adhesions can not be separated, patients with intolerance and other conditions should be promptly switched to transit thoracotomy surgery, so as to avoid the serious consequences of life-threatening patients.