目的　探讨在X线透视配合下电视胸腔镜在自发性气胸治疗中的作用。方法　对 10 3例自发性气胸病人施行电视胸腔镜手术 ,其中原发性气胸 79例 ,继发性气胸 2 4例 ;手术指证为 :(1)气胸有反复发作史 ,(2 )胸腔闭式引流后仍持续性漏气 (>7d)者 ,(3)合并有血胸、胸腔积液者 ,(4)初次发作CT扫描发现有明确的肺大泡者。结果　无手术死亡病例 ,中转开胸率为 2 .91% ,复发率为 0 .97% ,并发症发生率为 3.81% ,平均术后住院天数为 5 .6d。结论　在治疗自发性气胸中 ,电视胸腔镜手术是一种优于常规开胸手术和内科保守治疗的治疗方法。 Objective To investigate the role of video-assisted thoracoscopy in the treatment of spontaneous pneumothorax under X-ray fluoroscopy. Methods Thirty-three patients with spontaneous pneumothorax underwent video-assisted thoracoscopic surgery, including 79 cases of primary pneumothorax and 24 cases of secondary pneumothorax. Surgical indications were as follows: (1) history of recurrent pneumothorax, (2) closed thorax Persistent leakage after drainage (> 7d), (3) with hemothorax, pleural effusion, (4) the first episode of CT scan revealed a clear bullae. Results There were no cases of surgical death. The rate of open thoracotomy was 2.91%, the recurrence rate was 0.97% and the complication rate was 3.81%. The average postoperative hospital stay was 5.6 days. Conclusion In the treatment of spontaneous pneumothorax, video-assisted thoracoscopic surgery is a better treatment than conventional thoracotomy and conservative medical treatment.