内科胸腔镜结合深部热疗治疗包裹性结核性胸膜炎的有效性及对肺功能、凝血指标的影响  

Efficacy of Medical Thoracoscopy Combined with Deep Hyperthermia in the Treatment of Encapsulated Tuberculous Pleurisy and Its Influence on Pulmonary Function and Coagulation Indexes

作　　者：张海霞 李丹华[2] ZHANG Haixia;LI Danhua(Dingzhou People’s Hospital,Dingzhou 073000,China;不详)

机构地区：[1]定州市人民医院,河北定州073000 [2]保定市第二中心医院

出　　处：《中外医学研究》2022年第2期9-12,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：保定市科技计划项目(18ZF235)。

摘　　要：目的:探究内科胸腔镜结合深部热疗治疗包裹性结核性胸膜炎的有效性及其对患者肺功能、凝血指标的影响。方法:将定州市人民医院2017年1月-2019年12月收治的66例包裹性结核性胸膜炎患者通过随机数字表法分为人数均等的研究组和对照组,给予对照组常规胸腔穿刺引流和抗结核治疗,研究组则联合应用内科胸腔镜下粘连松解和深部热疗,分析两组在手术指标、肺功能、凝血功能方面的差异。结果:研究组胸腔积液消失时间早于对照组,住院时间短于对照组,胸腔积液抽出总量少于对照组,差异均有统计学意义(t=4.760、6.802、15.179,P=0.000);治疗前两组用力呼气肺活量(FVC)及1 s用力呼气容积(FEV_(1))水平差异无统计学意义(P>0.05),治疗后两组肺功能指标均有一定改善,且研究组各指标水平均明显高于对照组(t=5.751、4.249,P=0.000);治疗前两组凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、血小板(PLT)水平差异无统计学意义(P>0.05),治疗后两组凝血功能各指标水平均有所下降,但研究组高于对照组(t=6.170、4.137、8.515,P=0.000)。结论:给予包裹性结核性胸膜炎患者深部热疗和内科胸腔镜联合治疗可以有效清除患者胸腔内粘连和胸腔积液,促进患者肺功能的提高,同时还能减小对患者凝血功能的影响,是一种有效的临床治疗方案。Objective:To investigate the effectiveness of medical thoracoscopy combined with deep hyperthermia in the treatment of tuberculosis pleurisy and its influence on pulmonary function and coagulation index.Method:A total of 66 patients with wrapped tuberculosis pleurisy treated in Dingzhou People’s Hospital from January 2017 to December 2019 were divided into the same number of study group and control group.The control group was given routine thoracic puncture drainage and anti tuberculosis treatment.The study group combined with internal thoracic adhesion release by thoracoscopy and deep thermal treatment,and the surgical indexes,pulmonary function,coagulation function of the two groups were analyzed.Result:The time of disappearance of pleural effusion in the study group was earlier than that in the control group,hospitalization in the study group was shorter than that in the control group and total amount of pleural effusion in the study group was less than that in the control group,the differences were significant(t=4.760,6.802,15.179,P=0.000).There were no significant differences in FVC and FEV;levels between the two groups before treatment(P>0.05).After treatment,the lung function indexes of the two groups were improved and the level of index in the study group were significantly higher than those of the control group(t=5.751,4.249,P=0.000).There were no significant difference in PT,APTT and PLT levels between the two groups before treatment(P>0.05).After treatment,the blood coagulation function of the two groups decreased,but the study group were higher than those of the control group(t=6.170,4.137,8.515,P=0.000).Conclusion:The combined therapy of deep heat therapy and medical thoracoscopy can effectively remove the adhesion and pleural effusion in patients with the inclusion tuberculosis pleurisy,promote the improvement of pulmonary function,and reduce the influence on the coagulation function of patients.It is an effective clinical treatment plan.

关 键 词：内科胸腔镜 深部热疗 包裹性结核性胸膜炎 肺功能 凝血指标 

分 类 号：R521.7[医药卫生—内科学]