Progress in the application of minimally invasive rapid rehabilitation surgery in the treatment of primary spontaneous pneumothorax

doi:10.3877/cma.j.issn.2095-8773.2018.04.09

Abstract

Abstract:

Primary spontaneous pneumothorax (PSP) is a common chest disease.Most patients are complicated with bullae formation, and the condition is serious.There are various treatments, including conservative treatment, thoracotomy, and video-assisted thoracoscopic surgery(VATS). All treatments have their own advantages and disadvantages.Different treatment processes have different effects.This article reviews the international and domestic researches in diagnosis of PSP, clinical application of fast track surgery (FTS), and other treatments for PSP in recent years.

Key words: Primary spontaneous pneumothorax, Video-assisted thoracoscopic surgery, Fast track surgery

Qinghuai Wang, Ning Tan. Progress in the application of minimally invasive rapid rehabilitation surgery in the treatment of primary spontaneous pneumothorax[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2018, 05(04): 243-247.

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项目	常规手术治疗	单孔VATS＋FTS方式治疗
术前禁食、禁饮	常规禁食12 h，禁饮4 h	禁食6 h，禁饮2 h
插尿管	术前插尿管，术后留置2～4 d	麻醉后再插尿管，术后36 h内予以拔除
麻醉＋手术方式	全身麻醉＋常规手术	全身麻醉＋常规手术
留置胸腔闭式引流管	常规选择30号引流管，胸腔引流液体≤100 ml/d，拔除引流管，留置2～5 d	18号胸腔引流管，术后36 h内拔除
术中输液	不控制输液量，由麻醉师选择液体量	液体控制在25～30 ml/kg，以胶体输液为主
术后镇痛情况	根据患者的需要应用口服或肌注止痛药	自控镇痛泵(静脉留置应用2～36 h)＋口服、肌肉注射综合用药
术后饮食	一般在术后第2天进饮食	术后6 h予以饮食，以碳水化合物为主
术后早期下床活动情况	一般拔除胸腔闭式引流管后，即术后第3～5 d	术后24～36 h
手术时机选择	入院72 h后手术治疗	入院72 h内手术治疗
`雾化吸入	术后第2天开始	术后当天开始

项目	常规手术治疗	单孔VATS＋FTS方式治疗
术前禁食、禁饮	常规禁食12 h，禁饮4 h	禁食6 h，禁饮2 h
插尿管	术前插尿管，术后留置2～4 d	麻醉后再插尿管，术后36 h内予以拔除
麻醉＋手术方式	全身麻醉＋常规手术	全身麻醉＋常规手术
留置胸腔闭式引流管	常规选择30号引流管，胸腔引流液体≤100 ml/d，拔除引流管，留置2～5 d	18号胸腔引流管，术后36 h内拔除
术中输液	不控制输液量，由麻醉师选择液体量	液体控制在25～30 ml/kg，以胶体输液为主
术后镇痛情况	根据患者的需要应用口服或肌注止痛药	自控镇痛泵(静脉留置应用2～36 h)＋口服、肌肉注射综合用药
术后饮食	一般在术后第2天进饮食	术后6 h予以饮食，以碳水化合物为主
术后早期下床活动情况	一般拔除胸腔闭式引流管后，即术后第3～5 d	术后24～36 h
手术时机选择	入院72 h后手术治疗	入院72 h内手术治疗
`雾化吸入	术后第2天开始	术后当天开始

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