气管插管与非气管插管在胸腔镜肺癌手术中临床效果比较  

Comparison between the clinical effect of tracheal intubation and non-tracheal intubation in thoracoscopic lung cancer surgery

作　　者：张继琛[1] 娄凯[1] 杨泽山[1] 陈巍[1] 

机构地区：[1]浙江省台州市第一人民医院心胸外科,浙江台州318020

出　　处：《中国现代医生》2017年第21期49-52,共4页China Modern Doctor

基　　金：浙江省医药卫生科技计划项目(2012KYB246)

摘　　要：目的通过临床指标及免疫指标比较气管插管(非自主呼吸)与非气管插管(保留自主呼吸)在肺癌手术中的临床效果。方法选择2014年12月~2015年5月,我院符合本实验纳入标准的患者40例,分为气管插管组20例,非气管插管组20例。比较两组临床指标及相关免疫指标优劣。结果非气管插管组患者平均手术时间、术中出血量、术后引流液量、术后拔管时间、下床活动时间、术后住院时间、住院费用等方面较气管插管组有明显优势,差异有统计学意义(P<0.05)。非气管插管组CD3淋巴细胞、CD4淋巴细胞、白介素-6(IL-6)、白介素-12(IL-12)、细胞刺激因子(NKSF)、NK细胞、肿瘤坏死因子(TNF-α)均明显低于非气管插管组,差异有统计学意义(P<0.05)。结论两组手术方法均对机体产生一定的免疫作用,但是非气管插管胸腔镜手术比气管插管胸腔镜手术的效果更好,手术时间短,免疫影响小、恢复更快,安全可靠,值得临床上推广。Objective To compare the clinical effect of tracheal intubation（non-spontaneous respiration） and non-tra- cheal intubation（spontaneous breathing） in lung cancer surgery by clinical indices and immune indices. Methods From December 2014 to May 2015, 40 cases who conformed to the inclusion criteria of the experiment in our hospital were divided into tracheal intubation group of 20 cases and non-tracheal intubation group of 20 cases.The upsides and downsides of clinical indices and related immune indices were compared between the two groups. Results The average operation time,intraoperative blood loss, postoperative drainage volume, postoperative extubation time,off-bed activity time, postoperative hospital stay and hospitalization expenses in the non-tracheal intubation group were significantly higher than those in the tracheal intubation group. The differences were statistically significant （P〈0.05）. CD3 lympho- cytes, CD4 lymphocytes, interleukin-6 （IL-6）, interleukin-12 （IL-12）, cell stimulating factor （NKSF）, NK cells and tu- mor necrosis factor （TNF-α） in the non-tracheal intubation group were all significantly lower than those in the tracheal intubation group, and the differences were statistically significant（P〈0.05）. Conclusion The surgical methods of the two groups have a certain immune effect on the body. However, the thoracoscopic surgery in the non-tracheal intubation group has a better effect than that in the tracheal intubation group, with shorter operation time, smaller immune effect and faster recovery,which is safe and reliable,and worthy of clinical promotion.

关 键 词：气管插管 非气管插管 肺癌 细胞因子 

分 类 号：R734.2[医药卫生—肿瘤]