Video-assisted thoracoscopic surgery （VATS） for bilateral primary spontaneous pneumothorax

Objective:To review our experience of the treatment of bilateral primary spontaneous pneumothorax (PSP) by video-assisted thoracoscopic surgery (VATS). Materials and methods: Retrospective chart review was followed by an on-clinic or telephone interview. Patients were cared for by one thoracic surgeon in four medical centers or community hospitals in Northern and Central Taiwan. Thirteen patients with bilateral PSP underwent bilateral VATS simultaneously or sequentially from July 1994 to December 2005. Results: Twelve males and one female, with age ranging from 15 to 36 years (mean 23.1 years), were treated with VATS for bilateral PSP, under the indications of bilateral pneumothoracis simultaneously (n=4) or sequentially (n=9). The interval between the first and second contra-lateral VATS procedure for non-simultaneous PSP patients ranged from 7 d to 6 years. Eleven of 13 patients (84.6%) had prominent pulmonary bullae/blebs, and underwent bullae resection with mechanical or chemical pleurodesis. The mean operative time was (45.6±18.3) min (range 25-96 min) and (120.6±28.7) min (range 84-166 min) respectively for the non-simultaneous (second VATS for the recurrence of contralateral side after first VATS) and simultaneous (bilateral VATS in one operation) procedures. There was no postoperative mortality. However, prolonged air leakage (>7 d) occurred in one patient (7.7%) who recovered after conservative treatment. The mean duration of chest tube drainage was 3.1 d and the median follow up period was 3.4 years. Conclusions: VATS is a safe and effective procedure in the treatment of bilateral PSP. Bilateral VATS is only recommended for patients with simultaneously bilateral PSP, because the incidence of recurrence, even with visible bullae, was not so high in my group and in some previous literature. Bilateral VATS in a supine position should only be used in selective cases, because of possible pleural adhesion or hidden bullae on the posterior side.     

70例自发性气胸临床分析

对７０例自发性气胸进行了临床分析,自发性气胸多发于男性青少年,右侧多见,其中又 原发性气胸发生率为高（７１％）,继发性气胸原发病主要为慢性阻塞性肺部疾病和肺结核,部分（５１％）有明显诱因,复发率达２６％,卧床休息、胸腔抽气术、胸腔闭式引流术仍是目前应用最普遍的疗法,其总有效率达８５％,治疗中严重并发症为重复和张性肺水肿,少数病例需手术治疗。     

自发性液气胸的早期诊断——附两例病例报告

目的 为探讨自发性液气胸的早期诊断.方法 采用临床病例回顾对比法进行.结果 两例均为年轻健康者,无外伤史,突然感觉胸闷、胸痛、进行性呼吸困难而求医.检查见患者呈急性病容,呼吸困难,纵隔及气管向健侧移位,肺部未闻及干湿性啰音,病侧呼吸音消失.血象检查为正常值,胸部摄片为液气胸.结论 此病发病较快,呈进行性,应早期进行X线检查,以求早期得以治疗.     

林志玲：6根肋骨的价格

“台湾第一名模”林志玲7月8日在大连拍摄广告时意外坠马，胸部6根肋骨骨折，同时引起少量血气胸及肺挫伤。一时间，港、台、内地诸多媒体蜂拥至大连。     

青年与中老年自发性气胸特征比较

本文对120例自发性气胸进行临床分析。按年龄分为青年人自发性气胸(≤10岁)和中老年自发性气胸(>40岁)。发现二者之间在发病原因,临床表现,并发症,治疗方法及预后等方面均存在明显差异。     

心肌挫伤患者的护理

目的探讨胸部闭合性损伤致心肌挫伤患者的护理模式,减少损伤后并发症的发生,降低心肌挫伤患者的病死率。方法回顾性分析2002年7月至2011年5月收住西藏自治区人民医院急救中心确诊为心肌挫伤的65例患者的临床及护理资料。结果 65例心肌挫伤的患者经过积极的抢救和合理、高效及综合的护理措施,63例(96.9%)患者临床治愈,2例(3.1%)死亡,其中1例(1.5%)患者死于心包填塞,另外1例(1.5%)患者死于室性心律失常。结论早期诊断、积极的抢救措施以及合理、高效和综合的护理模式是改善心肌挫伤患者预后的关键。     

CT引导下经皮肺穿刺活检并发气胸行管引流治疗效果观察

目的:研究CT引导下经皮肺穿刺活检术后并发气胸的细管胸腔闭式引流治疗效果。方法:对某院自2001年1月至2005年9月CT引导下经皮肺穿刺活检术后发生的53例气胸患者中有较明显胸闷、气促的6例患者进行细管(选用16号20cm长中心静脉导管)胸腔闭式引流的疗效观察。结果:6例患者气胸全部治愈,肺复张时间(指插管至肺完全复张所需时间)1～3天,效果满意,未出现并发症。结论:CT引导下经皮肺穿刺活检使用细针(20G切割针),并发气胸时胸膜破裂口较小,往往形成闭合性气胸,使用细管胸腔闭式引流治疗不仅取材容易,操作简便,病人痛苦少,而且疗效满意,无并发症,值得临床推广使用。     

胸腔置管接持续低负压吸引治疗自发性气胸病人的护理体会

胸腔置管接持续低负压吸引是近几年临床采用治疗自发性气胸的有效方法,对36例自发性气胸患者采用胸腔置管接持续低负压吸引的护理问题进行探索,使患者病程缩短,减少皮下气肿,胸腔感染,复张性肺水肿等并发症的发生,取得满意的治疗效果。     

Video-assisted thoracic surgery——the past, present status and the future

Video-assisted thoracic surgery （VATS） has developed very rapidly in these two decades, and has replaced conventional open thoracotomy as a standard procedure for some simple thoracic operations as well as an option or a complementary procedure for some other more complex operations. In this paper we will review its development history, the present status and the future perspectives.     

农村初中学生体质与健康状况的分析与思考——从“气胸”现象谈起

体育教师是增强学生体质,增进学生健康的主要参与者与组织者,体育教师应尊重、关心、爱护学生,承认个体差异。不能为一时的功利主义思想所迷惑,真正从关心学生的健康与成长着想,认真学习并贯彻《新课程标准》。