金晓明，金晓明。AU - Boutin, C. AU - Astoul, P. AU - Janssen, J-P。AU -葛兰丁，S. AU -博利格尔，C-T。AU - Delaunois, L. AU - Driesen, P. AU - Tassi, G. AU - Perruchoud, a . p。通过医学胸腔镜治疗原发性自发性气胸AU -， TI - Talcage比引流更划算:一项随机研究:AID - 10.1188 /09031936.02.00278202 DP - 2002年10月01日TA -欧洲呼吸杂志PG - 1003—1009 VI - 20 IP - 4 4099 - //www.qdcxjkg.com/content/20/4/1003.short 4100 - //www.qdcxjkg.com/content/20/4/1003.full SO - Eur Respir J2002年10月01日;20 AB -单纯胸腔镜talcage (TT)是治疗原发性自发性气胸(PSP)的一种安全有效的方法。然而，与标准的保守治疗(胸膜引流(PD))相比，其疗效此前未被评估。在这项前瞻性随机比较的两种公认的治疗PSP的方法中，至少需要一根胸管，对108例PSP患者(61例TT和47例PD)的成本效益、安全性和疼痛控制进行了评估。两组患者具有相似的临床特征。TT和PD患者的引流和住院时间相似。 There were no complications in either group. The immediate success rate was different: after prolonged drainage (>7 days), 10 out of 47 PD patients, but only 1 out of 61 TT patients required a TT as a second procedure. Total costs of hospitalisation including any treatment procedure were not significantly different between TT and PD patients. Pain, measured daily by visual analogue scales, was statistically higher during the first 3 days in TT patients but not in those patients receiving opiates. One month after leaving hospital, there was no significant difference in residual pain or full working ability: 20 out of 58 (34%) versus 10 out of 47 (21%) and 36 out of 61 (59%) versus 26 out of 39 (67%) in TT versus PD groups, respectively. After 5 yrs of follow-up, there had been only three out of 59 (5%) recurrences of pneumothorax after TT, but 16 out of 47 (34%) after conservative treatment by PD. Cost calculation favoured TT pleurodesis especially with regard to recurrences. In conclusion, thoracoscopic talc pleurodesis under local anaesthesia is superior to conservative treatment by chest tube drainage in cases of primary spontaneous pneumothorax that fail simple aspiration, provided there is efficient control of pain by opioids. This study was supported by the Lancardis Foundation, 1920 Martigny, Switzerland.