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儿童及青少年的胸腔镜检查

Thoracoscopy in children and adolescents.

作者信息

de Campos J R, Andrade Filho L O, Werebe E C, Minamoto H, Quim A O, Filomeno L T, Jatene F B

机构信息

Department of Thoracic Surgery, University of São Paulo Medical School, Brazil.

出版信息

Chest. 1997 Feb;111(2):494-7. doi: 10.1378/chest.111.2.494.

Abstract

STUDY OBJECTIVES

Present the feature characteristics of the use and findings of thoracoscopy in children and adolescents.

DESIGN

From February 1983 to February 1996, 77 thoracoscopic procedures were done on patients ranging in ages from 5 months to 18 years (mean, 9.8 years). Two-thirds (66.2%) were male. They were divided into three groups (1, 2, and 3) based on age (up to 2, from 2 to 8, and older than 8 years), predominance of certain diseases in these ages, and the size of the instruments utilized. They were operated on using general anesthesia with Carlens' mediastinoscope routinely used in 64 (83%) and videothoracoscopy in 13 (17%). The chief indication for therapeutic thoracoscopy was treatment of empyema, while for diagnostic thoracoscopy it was pleural biopsy and diagnosis of pleural effusions.

RESULTS

In group 1, thoracoscopy was solely for the treatment of pleural disorders. In group 2, it was for the treatment of pleuropulmonary diseases. Group 3 behaved almost like adults, with broad diagnostic and therapeutic indications for thoracoscopic procedure.

CONCLUSIONS

Thoracoscopy, which is a useful diagnostic and therapeutic procedure, has secured an important place in pediatric surgical practice.

摘要

研究目的

介绍儿童和青少年胸腔镜使用情况及检查结果的特征。

设计

从1983年2月至1996年2月,对年龄从5个月至18岁(平均9.8岁)的患者进行了77例胸腔镜手术。三分之二(66.2%)为男性。根据年龄(2岁及以下、2至8岁、8岁以上)、这些年龄段某些疾病的优势以及所使用器械的大小,将他们分为三组(1组、2组和3组)。手术采用全身麻醉,64例(83%)常规使用卡伦斯纵隔镜,13例(17%)使用电视胸腔镜。治疗性胸腔镜的主要适应证是治疗脓胸,而诊断性胸腔镜的适应证是胸膜活检和胸腔积液的诊断。

结果

在1组中,胸腔镜仅用于治疗胸膜疾病。在2组中,用于治疗胸膜肺部疾病。3组的情况几乎与成人相似,胸腔镜手术具有广泛的诊断和治疗适应证。

结论

胸腔镜作为一种有用的诊断和治疗方法,在小儿外科实践中已占据重要地位。

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