单孔与多孔胸腔镜肺大泡切除术联合胸腔闭式引流术的应用效果比较  

Single versus multiple hole thoracoscopic bullae resection combined with closed thoracic drainage

作　　者：于文江[1] 岳志[1] 曹海伦 李剑桥 贾伟[1] 常王玉 段熊松 Yu Wenjiang;Yue Zhi;Cao Hailun;Li Jianqiao;Jia Wei;Chang Wangyu;Duan Xiongsong(Department of Cardiac and Thoracic Surgery,Fuyang Fifth People's Hospital,Fuyang 236000,China)

机构地区：[1]阜阳市第五人民医院胸心外科,236000

出　　处：《国际医药卫生导报》2020年第8期1086-1089,共4页International Medicine and Health Guidance News

摘　　要：目的探讨单孔胸腔镜与多孔胸腔镜肺大泡切除术联合胸腔闭式引流术的应用效果比较。方法选取2016年6月至2019年6月本院收治肺大泡患者58例,采用红蓝球随机法将患者分为对照组(n=28)与研究组(n=30),分别采用多孔(3孔)胸腔镜肺大泡切除术与单孔胸腔镜肺大泡切除术,两种术式均联合胸腔闭式引流,对比两组患者临床治疗效果。结果术后1 d、3 d、5 d、7 d,研究组VAS评分分别为(4.25±0.74)分、(3.66±0.21)分、(2.74±0.47)分、(1.94±0.84)分,均低于对照组,差异均有统计学意义(均P<0.05);两组患者术后肺功能相关指标、临床治疗效果比较,差异均无统计学意义(均P>0.05);研究组CRP、TNF-α、IL-8、PCT水平分别为(49.45±5.54)mg/L、(31.78±10.92)ng/L、(19.34±5.82)ng/L、(15.45±3.72)ng/ml,均低于对照组,差异均有统计学意义(均P<0.05);术前,两组患者免疫功能指标CD+3、CD+4比较,差异均无统计学意义(均P>0.05);术后1 d、7 d,研究组免疫功能指标CD+3、CD+4分别为(791.58±26.34)μl、(341.11±23.33)μl、(762.81±36.67)μl、(458.50±36.09)μl,均高于对照组,差异均有统计学意义(均P<0.05)。结论采用单孔胸腔镜肺大泡切除术治疗肺大泡可缓解手术后疼痛,降低应激反应提高免疫力,可临床推广。Objective To compare the effects of single hole thoracoscopy and porous thoracoscopic bullae resection combined with closed thoracic drainage.Methods From June,2016 to June,2019,58 patients with pulmonary bullae were treated in our department were selected,and were randomly divided into a control group(n=28)and a study group(n=30).The study group were treated with single-hole thoracoscopic pulmonary large-bubble resection and thoracic closed drainage,and the control group with multi-hole(3-hole)-assisted thoracoscopic lobectomy and thoracic closed drainage.The clinical treatment effects were compared between the two groups.Results 1,3,5,and 7 days,the VAS scores of the study group were(4.25±0.74),(3.66±0.21),(2.74±0.47),and(1.94±0.84),which were higher than those of the control group(all P<0.05).There were no statistical differences in postoperative pulmonary function and clinical effect between the two groups(all P>0.05).The levels of CRP,TNF-α,IL-8,and PCT were(49.45±5.54)mg/L,(31.78±10.92)ng/L,(19.34±5.82)ng/L,and(15.45±3.72)ng/ml in the study group,which were lower than those in the control group(all P<0.05).There were no statistical differences in CD+3 and CD+4 between these two groups before the operation(both P>0.05).1 and 7 days after the operation,the levels of CD+3 were(791.58±26.34)μl and(341.11±23.33)μl and the levels of CD+4 were(762.81±36.67)μl and(458.50±36.09)μl in the study group,which were significantly higher than those in the control group(all P<0.05).Conclusion Single hole thoracoscopic bullae resection can significantly reduce the amount of intraoperative bleeding,postoperative drainage and hospital stay,complications,and immunity,and relieve postoperative pain,reduce,so it is worth being popularized clinically.

关 键 词：单孔胸镜球囊切除术 多孔胸镜球囊切除术 闭式胸腔引流 效果比 

分 类 号：R65[医药卫生—外科学]