【摘要】：目的：對(duì)比兩孔式胸腔鏡肺葉切除術(shù)（two port thoracoscopiclobectomy TPTL）與傳統(tǒng)三孔式胸腔鏡肺葉切除術(shù)（three portthoracoscopic lobectomy TTTL）的臨床應(yīng)用效果，闡述TPTL在臨床治療中的意義及價(jià)值。 方法：回顧性分析行胸腔鏡下肺葉切除的154例患者的臨床資料，其中30例因合并高血壓、冠心病、糖尿病和慢性支氣管炎病史除外，余124例入組。按照其所行術(shù)式的不同分為TPTL組60例（采用TPTL、淋巴結(jié)廓清術(shù)），TTTL組（采用TTTL、淋巴結(jié)廓清術(shù)）64例，對(duì)比2組患者切口長(zhǎng)度(TPTL組：觀察孔+操作孔；TTTL組：觀察孔+操作孔+副操作孔)、手術(shù)時(shí)間、術(shù)中出血量、術(shù)后鹽酸哌替啶用量、術(shù)后拔除胸引管時(shí)間、術(shù)后住院時(shí)間、術(shù)后6個(gè)月患側(cè)上肢活動(dòng)后不適者的例數(shù)。 結(jié)果：TPTL組患者切口長(zhǎng)度為（4.0±0.2）cm，TTTL組患者切口長(zhǎng)度為（6.2±0.3）cm(P＜0.05)。TPTL組患者術(shù)后鹽酸哌替啶的用量為（125±35）mg，TTTL組患者術(shù)后鹽酸哌替啶的用量（240±46）mg（P＜0.05）。TPTL組2例患者術(shù)后6個(gè)月患側(cè)上肢活動(dòng)后不適，，TTTL組11例患者術(shù)后6個(gè)月患側(cè)上肢活動(dòng)后不適（P＜0.05）。兩組患者手術(shù)時(shí)間、術(shù)中出血量、術(shù)后拔除胸引管時(shí)間和術(shù)后住院日方面無(wú)統(tǒng)計(jì)學(xué)意義。 結(jié)論：TPTL較TTTL可以減小切口長(zhǎng)度、減輕術(shù)后疼痛、提高患者術(shù)后生活質(zhì)量，具有較高的臨床應(yīng)用價(jià)值。
[Abstract]:Aim: to compare the clinical effects of two-orifice thoracoscopic lobectomy (two port thoracoscopiclobectomy TPTL) and traditional three-orifice thoracoscopic lobectomy (three portthoracoscopic lobectomy TTTL), and to discuss the significance and value of TPTL in clinical treatment. Methods: the clinical data of 154 patients undergoing thoracoscopic lobectomy were retrospectively analyzed. The remaining 124 patients were enrolled in the group except for the history of hypertension, coronary heart disease, diabetes mellitus and chronic bronchitis in 30 patients with hypertension, coronary heart disease, diabetes mellitus and chronic bronchitis. According to the type of operation, 60 cases were divided into TPTL group (), TTTL group with TPTL, lymph node dissection and 64 cases with TTTL, lymph node dissection). The incision length was compared between two groups (TPTL group: observation of orifice operation hole); In TTTL group, the operation time, the amount of bleeding during operation, the dosage of pethidine hydrochloride after operation, the time of extubation of thoracic drainage tube, the length of hospital stay after operation, and the number of patients who were unfit after upper limb movement 6 months after operation were observed. Results: the incision length of TPTL group was (4 0 鹵0 2) cm,TTTL group, the incision length was (6 2 鹵0 3) cm (P < 0 05). TPTL group, the dosage of pethidine hydrochloride was (125 鹵35) mg, after operation. The dosage of pethidine hydrochloride in TTTL group (240 鹵46) mg (P < 0. 05). TPTL) was significantly lower than that in TTTL group (P < 0. 05), and that in TTTL group was less than 6 months after operation (P < 0. 05), while that in TTTL group was less than 6 months after operation (P < 0. 05). There was no significant difference in operative time, intraoperative bleeding, extubation of thoracic catheterization and postoperative hospital stay between the two groups. Conclusion: compared with TTTL, TPTL can reduce the length of incision, relieve postoperative pain and improve the quality of life of patients after operation.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R655.3

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