张玉喜 1庄著伦 1莫绪明 1孙剑 1彭卫 1戚继荣 1武开宏 1束亚琴 1王智琪1
作者信息
- 1. 南京医科大学附属南京儿童医院心胸外科 南京市，210008
- 折叠
摘要
Abstract
Objetive To compare the different clinical value of video-assisted thoracoscope surgery (VATS ) and the conventional thoracotomy lobectomy in infants and yong children via observa-tion. Methods Pulmonary lobectomies were carried on a total of 61 cases from June 2012 to December 2015.VATS lobectomy (VATS group)was carried on 22 cases,including video-assisted mini-thoracotomy lobectomy on 14 cases,and full thoracoscopic lobectomy on 8 cases.Conventional thoractomy (conventional group)was carried on 39 cases.The incision length,operation time,intraoperative bleeding volume,rate of blood transfu-sion,time for using breathing machine after operation,number of days for chest drainage volume greater than 2 mL·/kg -1 ·d -1 ,time for staying in ICU,incidence of complications,and the changes of white blood cells, C-reactive protein and serum procalcitonin during peri-operation. Results No severe complication and opera-tive death was recorded.There was no significant difference on ages,body weight,sites,pathological changes, and incidence of complications between VATS group and conventional thoracotomy group (P >0.05).There was statistical significance between VATS group and conventional thoracotomy group in incision length(2.87 ± 1.04 cm vs 8.25 ±2.32 cm ,t =-2.741,P =0.003),operation time(85.67 ±23.95 minutes vs 110.48 ± 32.71 minutes,t =-3.112,P =0.002),intraoperative bleeding volume(80.00 ±45.40 mL vs 143.04 ± 67.04 mL,t =-4.112,P =0.002),rate of blood transfusion was observed(P =0.043),number of days for chest drainage volume greater than 2 ml/kg·d(3.66 ±1.74 d vs 6.26 ±3.59 d,t =-4.305,P =0.000).In VATS group,number of cases with breathing machine after operation for more than 12 h,and cases in ICU time for more than 24 h were reduced in comparison with those in conventional thoracotomy group (P <0.05).The levels of white blood cell (5.68 ±1.59 ×109 /L vs 13.99 ±1.74 ×109 /L,t =-4.325,P =0.002),CRP (16.68 ±2.55 mg/L vs 25.63 ±4.67 mg/L,t =-6.613,P =0.000)and PCT(1.40 ±0.61 ng/mL vs 6.61 ±3.17 ng/mL,t =-7.372,P =0.002)in VATS group were significantly lower than that in conventional thora-cotomy group. Conclusions Compared with the conventional thoracotomy group,VATS group has characteris-tics of lower intraoperative bleeding volume,shorter time for using a ventilator and for duration in ICU,decreased postoperative irritability inflammation,and no significant difference in reducing the incidence of complications.关键词
胸腔镜/肺疾病/肺叶切除/儿童Key words
Thoracoscopes/Lungainly Diseases/Surgical Procedures,Operative/Child
