序贯通气联合胸腔镜在急诊手术治疗创伤性血气胸患者的效果及应激反应、血CRP水平的影响  

Effect of sequential ventilation combined with thoracoscope in emergency surgical treatment of traumatic hemopneumothorax and its influence on stress response and blood CRP level

作　　者：黄羊生 Huang Yangsheng(Emergency department,Longhua branch of Shenzhen people's hospital,Shenzhen,Guangdong,518109,China)

机构地区：[1]深圳市人民医院龙华分院急诊科,广东深圳518109

出　　处：《齐齐哈尔医学院学报》2021年第20期1776-1779,共4页Journal of Qiqihar Medical University

摘　　要：目的探究采用序贯通气联合胸腔镜在急诊手术治疗创伤性血气胸患者的临床效果、患者应激反应以及对血C反应蛋白(C-reactive protein,CRP)水平的影响。方法选择2012年3月—2018年5月在本科进行治疗的48例创伤性血气胸患者作为研究对象,按照随机数表法分为观察组和对照组两组,每组各24例。观察组使用序贯通气联合胸腔镜进行治疗,对照组采用胸腔镜进行手术并给予机械通气。对比两组患者治疗后的临床相关指标(止痛药使用量和使用时间、胸管引流量和引流时间以及住院时间)、术后并发症发生率、患者应激反应(应激皮质醇(Cortisol,Cor)、去甲肾上腺素(Norepinephrine,NE)、胰岛素(Insulin,Ins)、血管紧张素Ⅱ(AngiotensinⅡ,AT-Ⅱ))以及血CRP水平差异,对序贯通气联合胸腔镜用于急诊手术治疗创伤性血气胸患者的可行性进行分析。结果观察组患者止痛药用量、胸管引流量均明显低于对照组,且用药时间、引流时间、住院时间均明显短于对照组,差异有统计学意义(P<0.05);观察组患者术后不良反应发生率低于对照组,差异有统计学意义(P<0.05);手前,两组患者的C反应蛋白(CRP)、应激激素(Cor、NE、Ins、AT-Ⅱ)水平比较,差异无统计学意义(P>0.05);术后,观察组患者的CRP、Cor、NE、Ins、AT-Ⅱ均明显水平低于对照组,差异具有统计学意义(P<0.05)。结论使用序贯通气联合胸腔镜在急诊手术治疗创伤性血气胸患者能够有效提升临床疗效,降低并发症发生风险,降低患者CRP水平,减少应激反应,良好改善预后是具有较高价值的临床治疗方式。Objective To investigate the clinical effect of sequential ventilation combined with thoracoscope in the treatment of traumatic hemopneumothorax patients,and its effects on stress response and the blood C-reactive protein(CRP)level of patients.Methods 48 patients suffered with traumatic hemopneumothorax treated in our department from March 2012 to May 2018 were analyzed retrospectively.48 patients were randomly divided into two groups of observation group and control group according to the random number table method,24 in each group.The observation group was treated by sequential ventilation and thoracoscope,and the control group was operated by thoracoscope and mechanical ventilation.The clinical related indexes(analgesic dosage and time of use,thoracic catheter drainage amount and drainage time,and hospitalization time),postoperative complications,stress response(cortisol,cor;norepiephrine,NE;insulin,Ins;angiotensinⅡ,At-Ⅱ)and CRP level in blood were compared between the two groups.The feasibility of sequential ventilation combined with thoracoscope in emergency operation for patients with traumatic hemopneumothorax was analyzed.Results The dosage of painkillers,the amount of thoracic tube drainage in the observation group were significantly lower than that of the control group,and the time of administration,drainage time and hospitalization time were significantly shorter than that of the control group(P<0.05).The incidence of postoperative complications the observation group were significantly lower than that of the control group(P<0.05).There were no significant difference in CRP,stress hormone(COR,NE,INS,AT-II)levels between the two groups before operation(P>0.05).After treatment,the CRP,cor,NE,ins and AT-II levels in the observation group were significantly lower than those of the control group,and the results of the comparison between the two groups were statistically significant(P<0.05).Conclusions The use of sequential ventilation combined with thoracoscope in the treatment of traumatic hemopneumotho

关 键 词：序贯通气 胸腔镜 创伤性血气胸 临床疗效 应激反应 血CRP水平 

分 类 号：R561.4[医药卫生—呼吸系统]