Sortini A, Sciascia V, Navarra G, Carcoforo P, Santini M, Sartori A, Donini I
Istituto di Clinica Chirurgica Generale, Università degli Studi, Ferrara.
Minerva Chir. 1995 Nov;50(11):973-7.
The most frequent cause of spontaneous pneumothorax is bleb's disease of the lung. Considering that, pnx s. has a remarkable bent for relapsing, we think that it's necessary an aggressive treatment to resolve it. That's because pleural drainage is useful for a symptomatic resolution, VATS for an etiologycal one. To value the real efficacy of the treatment of VATS, we have effected a retrospective research between two classes of patients suffering from pnx s. admitted in our Institute from 1987 until 1991, one treated with pleural drainage (class A, 11 patients) and the other with VATS (class B, 13 patients). 1) Patients treated with pleural drainage were nearly double compared to class B. 2) In class A, the mean value of drainages were nearly double compared to class B. 3) Class A had a number of relapses 10 times more compared to B. 4) Considering the period of hospitalization, class A had a value nearly triple compared to B. 5) We've noticed that the mean value of the cost for episode of pnx s. in class A was more than 15% compared to class B and the cost for patient in class A was nearly double than in class B. We can affirm that, for the treatment of pnx s., the method of VATS rappresents a real success. We're passed from the "symptomatological treatment" of it to an aetiological one, joined to the prophylaxis of the relapse.
自发性气胸最常见的病因是肺大疱病。鉴于此，自发性气胸有显著的复发倾向，我们认为有必要采取积极的治疗措施来解决它。这是因为胸腔引流有助于缓解症状，而电视辅助胸腔镜手术（VATS）则针对病因进行治疗。为了评估VATS治疗的实际效果，我们对1987年至1991年期间在我院收治的两类自发性气胸患者进行了回顾性研究，一类采用胸腔引流治疗（A组，11例患者），另一类采用VATS治疗（B组，13例患者）。1）接受胸腔引流治疗的患者数量几乎是B组的两倍。2）A组的平均引流次数几乎是B组的两倍。3）A组的复发次数是B组的10倍。4）考虑住院时间，A组的数值几乎是B组的三倍。5）我们注意到，A组自发性气胸发作的平均费用比B组高出15%以上，A组患者的费用几乎是B组的两倍。我们可以肯定，对于自发性气胸的治疗，VATS方法是一个真正的成功。我们已经从对其的“症状性治疗”转变为病因性治疗，并结合了预防复发的措施。
