摘要目的 分析微创诊疗技术治疗进行性血胸的优势. 方法 选择2009年10月-2012年3月进行性血胸行微创治疗患者62例,根据治疗方法不同分为胸腔镜组(47例)和导尿管球囊封堵法组(15例),分别观察两组患者术后引流量及术后恢复情况. 结果 胸腔镜组47例患者均治愈,手术时间30 ～120 min,平均54 min,胸腔内清除积血700～2000ml,平均1 260 ml,均在胸腔镜下清除,术后复查床旁胸片提示肺复张良好,胸腔内无积血、积气.导尿管球囊封堵法组15例患者均治愈,术后3h内胸瓶引流量为100～500 ml鲜血性液体,平均260 ml,封堵成功之后未见大量血性液体流出,3h后复查胸部CT示胸腔积液量较前无明显增加. 结论 微创技术治疗中等量以下的进行性血胸疗效确切、创伤小、恢复快、并发症少,值得推广.

abstractsObjective To evaluate the advantages of minimally invasive technique for treatment of progressive hemothorax.Methods The study enrolled 62 patients with progressive hemothorax treated by minimally invasive surgery between October 2009 and March 2012.According to the treatment methods,the patients were classified to thoracoscope group (n =47) and urethral catheter balloon blockage group (n =15).Postoperative drainage volume and recovery were detected in both groups.Results All patients in thoracoscope group were healed with the mean operation time of 54 minutes (range,30-120 minutes).Mean effusion removed within thoracic cavity was 1 260 ml (range,700-2 000 ml).Postoperative bedside chest radiography revealed good pulmonary reexpansion without effusion or pneumatosis within thoracic cavity.All patients in urethral catheter balloon blockage group were healed.Chest drainage within postoperative 3 hours was mean 260 ml of fresh blood (range,100-500 ml) and thereafter no more massive bloody fluid discharge occurred.Meanwhile,chest CT reexamination revealed no increase of chest effusion.Conclusion Minimally invasive technique in treatment of progressive hemothorax patients with moderate or less effusion provides accurate effect,minor trauma,rapid recovery,and few complications and hence deserves clinical application.