目的 比较创伤后积留血胸直接经胸腔镜手术与经胸腔闭式引流术后胸腔镜手术疗效分析.方法 回顾分析该院5年来直接经VATS治疗外伤后积留血胸(胸腔镜组58例)与放置胸管后再行胸腔镜手术患者(胸管组71例)的手术时间、术中出血量、术后胸腔闭式引流管放置时间、术后肺不张发生率、平均住院时间.结果 两组患者均手术成功,胸腔镜组手术时间较胸管组短(P＜0.01)、辅助切口例数较胸管组少(P＜0.05),胸腔镜组术中出血量较胸管组少(P＜0.01),术后胸腔闭式引流管放置时间较胸管组短(P＜0.01),胸腔镜组术后肺不张发生率较胸管组少(P＜0.05),平均住院时间较胸管组短(P＜0.01).结论 积留血胸直接经胸腔镜手术创伤小,恢复快,术后并发症少,缩短住院时间.%[Objective] To compare the therapeutic effect of direct video-assisted thoracospic surgery (VATS) and VATS after tube thoracostomy for the management of posttraumatic hemothorax. [Methods] A total of 129 patients with retained hemothorax underwent direct VATS (VATS group, n=58) or VATS after tube thoracostomy (Tube group, n=71). The operation time, blood loss, and postoperative duration chest drainage were statistically analyzed. [Results] All the operations successed. Compared to the tube group, the VATS group had a shorter operation time (P <0.01), fewer assisted incision (P <0.05), less bleeding volume (P <0.01), shorter duration chest drainage (P< 0.01), less atelectasis (P<0.05), and shorter postoperative hospital stay (P<0.01). [Conclusion] Direct VATS for posttraumatic hemothorax can offer faster recovery and fewer complications, and shorter postoperative hospital stay.
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