胸腔镜外科手术在自发性气胸合并不同肺部基础疾病治疗中的应用效果  

Application effect of thoracoscopic surgery in the treatment of spontaneous pneumothorax complicated with different pulmonary diseases

作　　者：张卫宁 周波 ZHANG Wei-ning;ZHOU Bo(Thoracic Surgery Department, Xi'an XD Group Hospital, Xi'an 710077, China)

机构地区：[1]西电集团医院胸外科,陕西西安710077

出　　处：《临床医学研究与实践》2019年第11期56-58,共3页Clinical Research and Practice

摘　　要：目的研究探讨胸腔镜外科手术在自发性气胸合并不同肺部基础疾病治疗中的应用效果。方法选择2017年1月至2018年6月在我院就医的合并不同肺部基础疾病的80例自发性气胸患者进行前瞻性研究,采用随机数字表法将患者分为对照组和观察组,每组40例。对照组实施传统开胸手术治疗,观察组实施胸腔镜手术治疗。比较两组的手术情况、T淋巴细胞亚群指标、血清炎症因子水平、术后疼痛评分、术后并发症发生情况、术后胸腔引流情况、拔管时间及住院时间。结果观察组的手术切口长度短于对照组,术中出血量少于对照组(P<0.05);手术后,两组的CD3+水平、CD4/CD8均低于手术前,但观察组高于对照组(P<0.05);手术后,两组的CRP、IL-6、PCT水平均低于手术前,且观察组低于对照组(P<0.05);术后8、12、24、48 h,观察组的疼痛评分均低于对照组(P<0.05);观察组并发症总发生率为2.50%,显著低于对照组的17.50%(P<0.05);观察组胸腔引流量少于对照组,胸腔引流时间、拔管时间及住院时间均短于对照组(P<0.05)。结论胸腔镜手术治疗因不同肺部基础疾病所致的自发性气胸可有效减轻手术创伤,改善患者T淋巴细胞免疫功能,抑制炎症反应,减少术后并发症,加快患者术后恢复进程,值得临床推广应用。Objective To investigate the application effect of thoracoscopic surgery in the treatment of spontaneous pneumothorax complicated with different pulmonary diseases. Methods A prospective study was conducted on 80 patients with spontaneous pneumothorax complicated with different pulmonary diseases hospitalized in our hospital from January 2017 to June 2018. The patients were divided into control group and observation group using the random number table method,with 40 cases in each group. The patients in the control group were treated with traditional thoracotomy, and the patients in the observation group were treated with thoracoscopic surgery. The operation conditions, T lymphocyte subpopulation traits,levels of serum inflammatory factors, postoperative pain scores, postoperative complications, postoperative intrathoracic drainage, extubation time and hospitalization time were compared between the two groups. Results The length of the incision in the observation group was shorter than that in the control group, and the intraoperative blood loss was less than that in the control group(P <0.05). After operation, the levels of CD3+and CD4/CD8 in both groups were lower than those before operation, but those in the observation group were higher than the control group(P<0.05). After operation, the levels of CRP,IL-6 and PCT of the two groups were lower than those before operation, and those in the observation group were lower than the control group(P<0.05). At 8, 12, 24, 48 h after operation, the pain scores of the observation group were lower than those of the control group(P <0.05). The total incidence of complications in the observation group was 2.50%, which was significantly lower than 17.50% in the control group(P<0.05). The amount of intrathoracic drainage of the observation group was less than that of the control group, and the thoracic drainage time, extubation time and hospitalization time were shorter than those of the control group(P <0.05). Conclusion Thoracoscopic surgery for spontaneous pneumothorax caus

关 键 词：自发性气胸 胸腔镜 炎症因子 

分 类 号：R655[医药卫生—外科学]