胸腔镜应用在肺癌手术患者感染预防中的综合效果观察  

Combined effect of video-assisted thoracoscopic surgery applied in infection prevention for lung cancer patients

作　　者：刘瑜[1] 林晓铭[1] 池闯[1] 林超西[1] 

机构地区：[1]温州医学院附属第一医院胸心外科,浙江温州325000

出　　处：《中华医院感染学杂志》2011年第13期2694-2696,共3页Chinese Journal of Nosocomiology

摘　　要：目的比较电视胸腔镜手术与传统开胸手术的急性期反应程度,探讨胸腔镜应用在肺癌手术感染中的预防作用。方法将65例肺癌患者分为胸腔镜手术组(VATS组)35例和传统开胸手术组(CTH组)30例,统计术后两组感染病例,并检测手术前、手术后第1、3天的白细胞介素-6(IL-6)和CRP浓度。结果 VATS组肺部感染1例,切口感染0例,CTH组肺部感染8例,切口感染4例,经过有效引流,选用敏感抗菌药物,加强支持疗法治愈;术前VATS组IL-6和CRP浓度分别为(27.58±3.30)pg/ml、(7.29±3.24)mg/L,CTH组为(30.40±4.25)pg/ml、(7.38±3.46)mg/L;术后第1、3天VATS组IL-6浓度分别为(83.15±18.91)、(55.49±9.87)pg/ml,CTH组为(117.55±23.34)、(74.14±13.71)pg/ml;术后第1、3天VATS组CRP浓度分别为(67.43±10.27)、(48.83±16.28)mg/L,CTH组为(98.72±11.73)(、65.23±19.81)mg/L,两组术前IL-6和CRP的浓度均差异无统计学意义;而在术后第1、3天血清IL-6和CRP浓度VATS组均低于CTH组,差异有统计学意义。结论胸腔镜手术较传统的开胸手术创伤小,术后炎症迅速减轻,从而有效预防术后感染。OBJECTIVE To compare the acute inflammatore reactions after video-assisted thoracoscopic surgery （VATS） and conventional thoracotomy （CTH）, application of thoracoscopy in lung cancer surgery in the prevention of infection. METHODS A total of 65 patients with lung cancer were randomly assigned to the VATS group （n=35） and the conventional thoracotomy group （n=30）. Serum IL-6 and C-reactive protein （CRP） were detected respectively before operation,at 1 day after operation,and at 3 days after operation. RESULTS In VATS group, 1 case with pulmonary infection, 0 case with wound infection, while CTH group , pulmonary infection in 8 cases, wound infection in 4 cases. IL-6 and CRP were （27.58±3.30） pg/ml, （7.29±3.24） mg/L in VATS group and （30.40±4.25） pg/ml,（7. 38±3. 46） mg/L in CTH group before operation. IL-6 was （83.15±18.91） pg/ml,（55.49±9.87）pg/ml in VATS group and （117.55±23.34）pg/ml,（74.14± 13. ？l）pg/ml in CTH group on first day and third day after operation. CRP were （67.43± 10. 27）mg/L, （48. 83± 16. 28）mg/L in VATS group and （98.72±11.73）rag/L,（65.23±19.81）mg/L in CTH group on first day and third day after operation. The levels of serum IL-6 and CRP did not differ statistically between the two groups before operation, while the levels of serum IL-6 and CRP were significantly lower in VATS group than in CTH group at 1 to 3 days after operation. CONCLUSION Compared with conventional thoracotomy, video-assisted thoracoscopic surgery has less surgical trauma, milder inflammatory reaction, and can prevent postoperative infection.

关 键 词：胸腔镜手术 开胸手术 C-反应蛋白 白细胞介素-6 术后感染 

分 类 号：R181.32[医药卫生—流行病学]