| Primary spontaneous pneumothorax(PSP)is the most common thoracic disease in clinical department of thoracic surgery,especially in emergency department.Symptomatic patients should be excluded from the pleural cavity as soon as possible,so as to restore the lungs as soon as possible,to restore gas exchange function,and to prevent recurrence as much as possible.Many methods of clinical treatment of pneumothorax,pleural cavity gas out of the most basic method is coarse needle syringe after thoracic puncture pumping,or pleural drainage with sterile water seal bottle closed for gas drainage;non conservative treatment: mainly classic double lumen endotracheal intubation under general anesthesia or single lumen endotracheal intubation for cesarean section thoracic surgery,and in recent years more and more mature of video-assisted thoracoscopic surgery(VATS),so that the basic alternative to open surgery.Pneumothorax treated conservatively with high recurrence rate cannot be controlled,according to reports by conservative treatment of patients with pneumothorax recurrence rate between about 20-60% [1,2],and the chance of recurrence increases gradually as the frequency of recurrence increases.Whether classical open surgery or video-assisted thoracoscopic surgery in recent years can significantly reduce the recurrence rate,however,the recurrence rate after PSP is still 3.5-9.4%,with an average of 5.5%[3].Pneumothorax recurrent attacks are not accepted by patients and doctors,so how to reduce the recurrence rate of patients is an urgent need to solve the problem.Through the retrospective analysis of previous treatment with VATS PSP with relevant information,systematic and comprehensive statistical analysis,and discussed in detail in the results after the conclusion,in order to seek a higher risk factors of recurrent pneumothorax after operation,.For further treatment of postoperative recurrence is again to conservative or aggressive surgical,are more difficult decisions,patients and their families are more difficult to accept,so reduce the relapse rate is particularly meaningful,to find out the risk factors,in order to improve the optimization,this is also the research significance.Method:Through medical records,telephone follow-up,outpatient follow-up,sixty follow-up system etc.were retrospectively analyzed from January 2010 to December 2014 in Tianjin Thoracic Hospital for the clinical data of 699 patients with primary spontaneous pneumothorax underwent VATS surgery,possible factors affecting postoperative relapse of postoperative statistical analysis.These factors were analyzed by single factor analysis and Logistic multivariate analysis.The software used is SPSS19.0 software,which is used for statistical analysis.The counting data in relevant factors are tested by chi square,and the measured data is checked by T in this software.Finally,the univariate statistical analysis of the statistical significance of the data for multi factor Logistic analysis,P>0.05 statistically no significant difference,P<0.05 statistically significant difference.Result:After investigation and follow-up,699 cases of primary spontaneous pneumothorax in the Tianjin Thoracic Hospital underwent VATS surgery,18 cases relapsed again,and the recurrence rate was 2.6%.Single factor analysis was carried out,the results suggest that postoperative recurrence of pneumothorax associated with the following factors(p<0.05),the number of pulmonary bullae,whether the lung recovered completely at first days after operation,family history,pulmonary bulla diameter,postoperative leakage time and postoperative intubation time,and has nothing to do with the following factors(p>0.05): age,height,weight,BMI,whether the first time,incidence the location of disease,sex,smoking,basal diameter.The results of Logistic analysis showed that whether the patient’s lungs were fully reopened first days after the operation was an independent risk factor for the recurrence of postoperative pneumothorax(P<0.05).Conclusion:Postoperative recurrence of pneumothorax associated with the following factors(p<0.05),the number of pulmonary bullae,whether the lung recovered completely at first days after operation,family history,pulmonary bulla diameter,postoperative leakage time and postoperative intubation time,and has nothing to do with the following factors(p>0.05): age,height,weight,BMI,whether the first time,incidence the location of disease,sex,smoking,basal diameter.The results of Logistic analysis showed that whether the patient’s lungs were fully reopened first days after the operation was an independent risk factor for the recurrence of postoperative pneumothorax(P<0.05).Therefore,it is of positive significance to strengthen perioperative management,reduce the omission of bullae,and promote postoperative pulmonary recruitment for the recurrence of postoperative pneumothorax. |
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