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目的 探讨电视胸腔镜手术 (VATS)在血胸处理中的适应证和禁忌证。方法 用VATS诊断和治疗血胸 34例。其中 12例为自发性血气胸 ,2 1例为创伤性血气胸 ,手术后血胸 1例。结果 平均手术时间 5 2 (2 5～ 130 ) min。术中从胸内平均清除血量 146 0 (4 0 0～ 34 0 0 ) ml。术后留置胸腔闭式引流管平均 1.5 (1～ 4) d。全组无手术死亡。无中转剖胸手术 ,亦无术后并发症。结论 VATS能彻底清除胸内积血和血凝块 ,并有效地止血和处理胸内合并损伤。尤其适应于自发性血胸、活动性血胸、凝固性或包裹性血胸以及并发化脓感染的血胸
Objective To investigate the indications and contraindications of VATS in hemothorax treatment. Methods VATS diagnosis and treatment of hemothorax in 34 cases. Twelve of them were spontaneous pneumothorax, 21 were traumatic hemothorax, and 1 was hemoblast after surgery. Results The average operation time was 5 2 (2 5 ~ 130) min. Intraoperative average removal of blood from the chest 146 0 (400 ~ 3400) ml. Postoperative closed thoracic drainage tube average 1.5 (1 ~ 4) d. The whole group died without surgery. No transfer thoracotomy, no postoperative complications. Conclusion VATS can completely remove intrathoracic hematuria and blood clots, and effectively stop bleeding and deal with intrathoracic combined injury. Especially adapted to spontaneous hemothorax, hemophilia, coagulation or hemopneumothorax and hemoptysis complicated by pyogenic infection