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目的：对比研究三孔胸腔镜和单孔电视胸腔镜治疗老年人自发性气胸，探究单孔电视胸腔镜治疗自发性气胸临床疗效。方法：将本院内2011 年2 月-2013 年11 月期间就诊的自发性气胸患者40 例纳入本次前瞻性研究，所有研究对象随机分为研究组对照组两组。研究组患者20 例采用单操作孔胸腔镜，对照组20 例采用三孔胸腔镜，对比分析两组的临床治疗效果。结果：研究组单孔手术操作时间（45.23± 12.4）min，对照组传统三孔手术操作时间（46.31± 11.8）min，差异无统计学意义的(t=0.346，P=0.731＞ 0.05)；研究组术中出血量（53.64± 5.9）mL 明显低于对照组的（68.72± 6.5）mL，差异显著(t=9.410，P=0.000＜0.05)；引流量对比中，研究组术后引流量为（298.6± 67.12）mL，对照组术后引流量为（371.8± 98.25）mL，组间有显著差异(t=3.369，P=0.001＜0.05)；两组患者疼痛时间对比，研究组对象疼痛持续时间显著少于对照组患者，数据差异具有统计学意义(t=4.712，P=0.000<0.05)。手术操作时间、住院天数等指标，组间数据均无统计学意义(P＞0.05)。对比两组术后随访情况，观察组的胸痛及切口麻木发生率均明显低于对照组的（P<0. 05）；而两组的腹胀性肺水肿发生率、心律失常发生率、肺部感染及复发率无显著性差异(P＞0.05)。结论：单孔电视胸腔镜手术治疗老年人自发性气胸临床疗效较好，其优势在于可有效减轻患者手术痛苦，且将是未来手术发展趋势，值得推广。

英文摘要:

Objective:To study the effects of three aperture and single aperture video-assisted thoracoscopic surgery on the treatment of spontaneous pneumothorax in aged patients, and to explore the clinical value of the single video-assisted thoracoscopic in treating spontaneous pneumothorax.Methods:In this prospective study, 40 patients with spontaneous pneumothorax during February 2011 to November 2013 were included. All subjects were randomly divided into the study group and the control group. The study group (20 cases) were treated with video-assisted thoracoscopic, the control group (20 patients) were treated using the three aperture thoracoscope, and clinical therapeutic effect of two groups was comparatively analysed.Results:The operation time of the study group was (45.23 ± 12.4) min, and was (46.31± 11.8) min for the control group, without significant statistical difference between two groups (t=0.346, P=0.346 >0.05); The bleeding amount of the study group (53.64 ± 5.9 mL) was significantly lower than that of the control group (68.72 ± 6.5 ml), presenting a significant difference (t =9.410, P=0.000<0.05); The drainage amount for the study group was (298.6± 67.12) mL, and was (371.8± 98.25) mL for the control group. There were a significant difference between the two groups (t =3. 369, P=0.001<0.05); The duration of painfulness post operation of the study group was significantly less than that of the control group, with a statistically significant difference (t=4.712, P=0.000<0.05). Indicators such as operation time, hospitalization days, presented no statistical significance between groups (P>0.05). Comparing the postoperative follow-up of the two groups, the incidences of chest pain and numbness in observation group were significantly lower than in the control group (P<0.05); the incidence of abdominal distension pulmonary edema, arrhythmia and pulmonary infection recurrence of showed no significant difference (P>0.05).Conclusion:Effect of single hole video-assisted thoracoscopic operation shows good efficacy in the treatment of senile spontaneous pneumothorax. The advantage is that it can effectively relieve the patients’pain post operation, it will be the development trend of future operations and is worthy of promotion.

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