胸腔镜下联合应用聚乙醇酸网片治疗原发性自发性气胸

摘要

目的 探讨胸腔镜下联合应用聚乙醇酸网片在治疗原发性自发性气胸中的临床价值.方法 在胸腔镜下使用切割缝合器对134例原发性自发性气胸行肺大疱切除139例次:补片组(96例次),在胸腔顶部壁层胸膜覆盖15 cmXl5 cm大小可吸收聚乙醇酸修补网片;对照组(43例次),仅行肺大疱切除.比较两组第一次手术后同侧复发次数.结果 补片组复发3例(3.2%),明显少于对照组的9例(20.9%)(P<0.01).结论 胸腔镜下使用聚乙醇酸修补网片覆盖胸腔顶部壁层胸膜可降低原发性自发性气胸术后复发率.%Objective To evaluate the clinical value of treating prinary spontaneous pneumothorax with polypropylene mesh under thoracoscopy. Methods Thoracoscopic bullectomy was performed in 134 patients with primary spontaneous pneumothorax(139 sites), of which video-assisted thoracic surgery(VATS) with a piece of polypropylene mesh covered on the apical visceral pleura was carried out in 96 sites(group A) and conventional thoracoscopic bullectomy was performed only in 43 sides (group B). Postoperative recurrence was compared between two groups. Results The postoperative recurrence rate was lower in group A than that in group B(3. 2％ vs. 20. 9％)(P＜0. 01).Conclusion Placement of polypropylene mesh on the apical pleura is a simple and useful method in preventing postoperative recurrence rate inthe patients with primary spontaneous pneumothorax underwent VATS.