胸腔镜肺大疱切除术中不同胸膜固定术的对比研究  

Application effect of different pleurodesis in thoracoscopic resection of bullae

作　　者：曾尚干[1] 

机构地区：[1]南昌大学第一附属医院胸外科,江西南昌330000

出　　处：《中国现代医生》2015年第31期33-35,共3页China Modern Doctor

摘　　要：目的探讨肺大疱胸腔镜手术治疗过程中不同胸膜固定术的效果。方法回顾性分析2012年1月～2014年12月胸腔镜肺大疱手术治疗患者83例的临床资料．根据术中胸膜固定方法分为胸膜摩擦组（21例）、滑石粉组（23例）及联合组（39例）。分析三组的临床疗效及术后并发症。结果联合组手术时间最长，其次为胸膜摩擦组，滑石粉组手术时间最短，差异有高度统计学意义（P〈0．01）；胸膜摩擦组术后住院时间显著长于滑石粉组和联合组（P〈0．05）；联合组体温38℃以上的比例显著高于胸膜摩擦组和滑石粉组（P〈0．01）；联合组肠外镇痛药物需求例次显著多于胸膜摩擦组和滑石粉组（P〈0.01）。胸膜摩擦组总的并发症发生率显著高于滑石粉组与联合组，差异有高度统计学意义（P〈0．01）。结论滑石粉和胸膜摩擦法均为有效的胸膜固定方法，滑石粉方法具有手术时间短、术后住院时间短、并发症发生率低等优点。Objective To discuss application effect of different pleurodesis in thoracoscopic resection of bullae. Methods Clinical data of 83 cases with thoracoscopic resection of bullae from Jan 2012 to Dec 2014 were respectively analyzed, and all cases were divided into pleural friction group（21 cases）, talc group（23 cases） and combination group （39 cases） according to different pleurodesis. Clinical efficacy and postoperative complications were analyzed. Results Operation time of combination group was longest, followed by pleural friction group, and talc group was shortest, which showed significant difference （P〈0.01）; Postoperative hospital stay of pleural friction group was longer than talc group and combination group（P〈0.05）; The cases above 38℃ of combination group were more than friction group and talc group （P〈0.01）. Parenteral analgesics needs of combination group were higher than pleural friction group and talc group （P〈0.01）. The overall complication rate of pleural friction group was higher than talc group and combination group （P〈0.01）. Conclusion Pleural friction and talc both are effective pleurodesis methods, but talc for pleurodesis shows shorter operative time, shorter postoperative hospital stay time and lower complication rate.

关 键 词：胸腔镜 肺大疱切除术 胸膜固定术 胸膜摩擦法 

分 类 号：R655[医药卫生—外科学]