| Objective:Respectively to contrast and study the clinical effect about the therapy of spontaneous pneumothorax by VATS under single and double operative holes.Methods:The observation with a randomly selected sample of 62 patients who received pulmonary bulla excision under VATS in the first affiliated hospital of Guangxi University of Traditional Chinese Medicine during May,2014 to December,2015.All of them were divided into two groups,the observing group and the contrast group.The observing group,consisting of32 patients,got therapies by VATS under single operative hole.The other one was contrast group be composed of the rest patients got thoracic surgeries under double operative holes.The research criteria contained 6 parts.They were the operative duration,the amount of operative hemorrhage,the score about the level of chest incision pain after operation according to the access standards of VRS and NRS,the thoracis draining volume after operative 48 hours,and the postoperative inflammatory mediator,at last was the time be spent in the hospital.Results : ??All patients were satisfied with the anesthetic processes.Furthermore,the whole operations were finished by VATS.??Operative duration was the first.The observing group average cost(102.280±22.569)minitus,the other one average cost(98.83±20.37)minitus.Meanwhile,the P was 0.314 more than 0.05.So,there was no statistical significance.Next,the amounts of operative hemorrhage.For the observing group,the bleeding volume was between(44.84±29.85)ml.As for the contrast group,that was between(43.830±23.400)ml,the P was 0.079 more than 0.05.Absolutely,there was no statistical significance.Then,the score about the level of chest incision pain.The grades of observing group on the postoperative first day,third day and seventh day were respectively(2.938±0.2322),(1.688±0.1938)as well as(0.4375±0.1573).As to the contrast group,these figures were(4.000±0.2139),(2.500±0.1852)and(1.000±0.1617).Moreover,the P1 was 0.0230.P3 was 0.0053.P7was0.0186.The three figures were all less than 0.05.So,there existed statistical significance,Next to compare the thoracic draining volume after operative 48 hours between the two groups.(197.00±18.54)ml were belong to the observing group.(180.00±17.41)ml were belong to the contrast group.Besides,the P was 0.0527 more than 0.05.Thus,there was no statistical significance.Following,the operative duration.The observing group was spent(15.000±1.881)days.The other one cost(17.7100±0.9693)days.And,the P was 0.1887 more than 0.05.Apparently,there was no statistical significance.At last was the inflammatory mediator,including C3/C4 and CRP.On the postoperative first day,third day as well as seventh day,the inflammatory mediators of observing group were respectively amount to(1.028±0.05517/0.4094±0.08343,72.11±13.64)?(1.183±0.09037/0.3025± 0.07662,92.06 ± 16.77)together with(1.113 ± 0.1157/0.4544 ±0.06747,72.49±15.32).As for the contrast group,those results were(1.183±0.09037/0.6005 ± 0.07202,92.06 ± 16.77)?(0.9761 ± 0.05837/0.5512 ±0.09237,110.7 ± 16.19)together with(0.9939 ± 0.04556/0.6006 ±0.07931,58.85 ± 7.284).Additional,P1 was range from 0.1250 to 0.4699.P3 was range between 0.0586 and 0.2309.P7 was among 0.3268 to 0.1755.There was no statistical significance of all parts more than 0.05.??Postoperative complications: No cases about the Pulmonary atelectasis of operative sides and the infection of lung be took place in the two groups sufficiently demonstrated that there was no more chance to cause the postoperative complications.Conclusions: Firstly,the therapy of spontaneous pneumothorax by VATS under single operative hole have the advantages of less pain and less probability of suffering from the postoperative complications,more accordant with the thoracic surgical theories of no pain and minimally invasive as well.Secondly,it is deserve to be popularized. |
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