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电视胸腔镜手术诊治胸腔疾病（作者:___________单位: ___________邮编: ___________）作者：夏伟利，李树满，李建国，索海进，方贵龙【摘要】目的探讨电视胸腔镜（Video-assisted thoracoscopic）手术诊治胸腔疾病的疗效。
方法自2007年9月-2009年2月，我院胸腔镜手术治疗自发性血胸、外伤性血胸以及难以诊治的胸腔积液及胸膜疾病12例。
术后均达到预期效果。
结果手术时间平均为60min，术中平均出血15ml，术后平均放置胸管时间56h，平均住院时间7天，无复发血胸、气胸或胸腔积液。
结论应用胸腔镜治疗血胸、胸腔积液疗效肯定，较传统开胸手术时间短，住院时间短，创伤小，经济，并能在直视下切取病变胸膜活检。
【关键词】胸腔镜；胸腔疾病；诊断与治疗【Abstract】Objective To discuss the curative effect of video asslsted thoracic operation for thorax disease. Methods In our hospital we carried out video asslsted thoracic operation on twelve patients with thorax diseases such as spontaneous hemothorax and traumatic haemothorax from Sep 2007 to Feb 2009. It wassatisfactory in all of cases after surgery operation.Results The average time with the operation for 60min, the average amount of bleeding in the operation for 15ml, the average time with the pleural canals placed for 56h, the average time being in hospital for 7d, no recidivist haemothorax, recidivist pneumatothorax or pleural effussion.Conclusion It is deserved affirmation about the curative effect to apply video asslsted thoracic operation to cure haemothorax and pleural effusion. As compared with the tradition opening thorax operation, it’s shorter than the before time of operation and being in hospital, the wound less than before, better economy, and direct exscinded pathological changes pleura below the orthoptic contemplation then delivered for the examining.【Key words】thoracoscope; thorax disease; diagnosis and treatment血胸、不明原因胸腔积液和胸膜疾病，过去我们常规实行开胸手术。
32现代医学仪器与应用2008年第20卷第1期M—od—ei—cal—Equi pm ent and A pp l i ca t i on Feb．2008．Y尘垫：堕!：1内科胸腔镜在胸膜疾病中的诊疗价值郑利先梅湛强罗志扬张培芳温业良刘剑【摘要】目的探讨内科胸腔镜在胸膜疾病中的诊疗价值。
方法对76例不明原因胸腔积液病人、3例自发性气胸病人行内科胸腔镜检查、活检及治疗，分别统计胸腔积液的确诊率及气胸的治愈率．并统计其不良反应及病人的顺应性。
结果76例不明原因胸腔积液病人中，确诊75例，占98．7％，病理结果分别为：结核性胸膜炎43例(56．6％)，恶性肿瘤31例(40．8％)，炎症l例(1．3％)，不明原因1例(1．3％)。
3例自发性气胸病人中发现肺大泡l例，胸膜粘连2例，经处理肺大泡或钳断粘连带后，气胸全部治愈。
所有病人均无严重并发症发生。
结论内科胸腔镜技术的介入．使胸膜疾病的诊断及治疗提高到了一个新的水平．且操作相对简单、安全性高，具有肯定的临床价值。
【关键词】胸腔镜；胸膜疾病；诊断；治疗T h e r ol e of m edi cal t horacos co py i n t he di a gnos i s an d t he ra py i n t he pl e ur al di s eas esZ H EN G L i xi an，M E I Z hanqi ang,L U O Z hi y ang，Z H A N G Pei fa ng，W E N Y e l i a ng，L I U Ji an"he Fir s t Peopl e's H ospi t al of F os han D epa r t m e nt of R es pi r a t or y M edi ci ne，G uangD ong，FoShan528000，Chi na)【A BST R A C T]O bj ect i ve T o exp l or e t he r o l e of m edi c al t hor a cos copy i n t he di a gnosi s and t he r apy i nt he pl eur a l di s eas es．M et hods76ca se s w i t h pl eur a l ef f us i on of unknow n ca us e s a nd3ca se s w i t h spont a neouspneum at ot hor a x r ece i ved t he exa m i na t i on、bi opsyand t he r apy of m edi c al t h or ac osc opy．T he n t he di a gnosi s accum-c y r a te of pl eur a l ef f u s i onand t he cu r e r at e of pneum a t ot hor a x w e r e a dd e d up，w hi l e t he s i de ef fect s and t he cor n-pl i ance of pat i ent s w e r eobs er ved．R es ul t s A m on g76ca se B w i t h pl eur a l ef f usi on of unknow n cau ses．75ca se sw er e di agnos ed def i nit ely．诵t Il t he ac cur ac y r at e of98．7％．A nd t he pat hol o gi cal r es u l t s：43ca se s w i t h t ub er cu l ouspl eur i fi s(56．6％)，31ca se s w i t h m a l i gna nt t um or s(40．8％)'1ca s e w i t h i nfl a m m at i on(1．3％)a nd1c a跎w i t h a n—know n ca use s(1-3％)．A m ong3ca se s of spont aneouspne um at ot hor ax，1ca gew i t h e m phys e m at ous bul l ae w h i l e2ca se s w i t h congl ut i nat i on of pl eum l cav i t y．Pneu m at o t hor ax w e陀a l l c ur ed af t er t he t he r apy of e m phys em a t ous bul-he and cut out t he cong l ut i n at i on．N o ser l ous co m pl i cat i ons oc cun℃d i n al l c刮s e f l．C o ncl u s i on s M edi c al t hor a-c os copy i m pr ovedt he di a gnosi s and t he r apy l ev el s of pl eur a l di s eas es．I t w ag eas il y ope r at ed w i t h l i t t l e seve r eco m pl i cat i ons and w a r r ant ed t o use w idel y．【K EY W O R D S】T ho m coscop y；Phu r al di s eases；D i ag nosi s；T her a py胸膜疾病是呼吸内科常见疾病。
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