局解手术学杂志2018，Vol.27Issue(2)：136-140,5.DOI:10.11659/jjssx.12E017073
胸腔镜联合机械通气在老年胸外伤患者并发急性呼吸窘迫综合征中的应用
Application of thoracoscope combined with mechanical ventilation in elderly patients with chest trauma compli-cated by acute respiratory distress syndrome
摘要
Abstract
Objective To investigate the application of thoracoscope combined with mechanical ventilation in elderly patients with chest trauma complicated by acute respiratory distress syndrome(ARDS).Methods Selected 49 elderly patients with chest trauma complicated by ARDS who were admitted into our hospital from Jan.2015 to Jun.2017 as the study objects.And divided these patients into the control group (n=25)and the observation group(n=24)upon the different treatment method.Patients of the control group underwent conventional thora-cotomy combined with mechanical ventilation,while patients of the control group underwent the microinvasive video -assisted thoracoscopic surgery(VATS)combined with mechanical ventilation.Post-operative incision size,duration of operation,intraoperative bleeding,severity of pain 5 days after surgery,drainage duration,patients with post-operative complication,and hospital stays after operation of all patients were e-valuated.Compared and analyzed the changes of pulmonary function before surgery and 1 week after surgery, as well as the VAS score and anxiety and depression of patients before and after surgery.Results The postoperative incision size,VAS score and operation time in the ob-servation group were significantly better those of the control group,and the difference was statistically significant(P<0.05).The postopera-tive complications of the observation group were significantly lower than that in the control group,and the difference was statistically signifi-cant(χ2=4.75,P<0.05).One week after treatment,the pulmonary function index of the observation group were obviously superior to the control group with statistically significant difference(P<0.05).And the improvement degree of anxiety and depression was better in the ob-servation group compared to the control group(P<0.05).Conclusion Compared to traditional thoracotomy,reasonable VATS will help to decrease the intra-operative bleeding,duration of operation,post-operative hospital stays,and number of complications after surgery.What is more,it can improve pulmonary function of elderly patients.In addition,it can relief the degree of anxiety and depression of patients after op-eration,which is better than ones accepting traditional thoracotomy.关键词
胸腔镜/机械通气/急性呼吸窘迫综合征/胸外伤Key words
thoracoscope/mechanical ventilation/acute respiratory distress syndrome/chest trauma分类
医药卫生引用本文复制引用
王钰姝,孙溦,任小宝,曾冬梅,吴敌,黄娟..胸腔镜联合机械通气在老年胸外伤患者并发急性呼吸窘迫综合征中的应用[J].局解手术学杂志,2018,27(2):136-140,5.基金项目
重庆市自然科学基金(CSTC2013jj B10005) （CSTC2013jj B10005）
