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目的 探讨电视胸腔镜手术 (VATS)在小儿胸部疾病诊治中的应用价值。 方法 对 4 1例平均年龄 6 9岁 (9d～ 16岁 ) ,平均体重 2 2 5kg(2 8～ 5 4 0kg)的患儿施行VATS ,其中 14例 <5岁。手术包括脓胸清除 15例、纵隔肿瘤活检或摘除 11例 ,肺楔形切除 6例 ,肺囊肿或肺隔离症行肺叶切除 5例、血胸清除与先天性膈疝处理各 2例。 结果全组患者平均手术时间 74min ,平均失血量 33ml(10～ 2 2 0ml)。术后留置胸腔引流管平均 2 4d ,平均住院 7d(4～ 15d)。术后并发症发生率 7 3% ,手术病死率 2 4 %。 4 0例患儿术后随访 15 6个月 (2 0～ 30 0个月 ) ,生长发育良好。结论 VATS能安全有效地用于小儿胸部疾病的诊断和治疗 ,这一新技术将在小儿胸外科占有重要的地位
Objective To investigate the value of VATS in the diagnosis and treatment of pediatric chest diseases. Methods VATS was performed in 41 children with a mean age of 6 9 years (9d ~ 16 years) and an average body weight of 225kg (28 ~ 5400kg), of whom 14 were less than 5 years old. Surgical operations included removal of empyema in 15 cases, mediastinal tumor biopsy or ablation in 11, wedge resection in 6, pulmonary cyst or pulmonary sequestration in 5 lobectomy, hemothorax removal and congenital diaphragmatic hernia in 2 patients. Results The average operation time of all the patients was 74min, the average blood loss was 33ml (10 ~ 220ml). Postoperative indwelling chest drainage tube average 24 days, the average hospitalized 7d (4 ~ 15d). The incidence of postoperative complications was 73% and operative mortality was 24%. 40 cases of children were followed up for 15 6 months (20 ~ 30 months), good growth and development. Conclusions VATS can be safely and effectively used in the diagnosis and treatment of pediatric chest diseases. This new technique will play an important role in pediatric thoracic surgery