CT引导下胸腔引流微管对肺气肿合并巨大肺大疱患者的疗效及安全性  

Efficacy and safety of CT-guided thoracic drainage microtubule for patients with emphysema complicated with giant pulmonary bullae

作　　者：陈健[1] 杨莉[2] 金杰 王磊 孙建军 董敏[5] 柴国祥 CHEN Jian;YANG Li;JIN Jie;WANG Lei;SUN Jianjun;DONG Min;CHAI Guoxiang(Department of Thoracic Surgery,Gansu Cancer Hospital,Lanzhou 730050,China;不详)

机构地区：[1]甘肃省肿瘤医院胸外一科,兰州730050 [2]甘肃省中医院心内科,兰州730050 [3]兰州市肺科医院呼吸内科,兰州730000 [4]兰州市肺科医院检验科,兰州730000 [5]甘肃省中医院呼吸科,兰州730050 [6]兰州市肺科医院胸外科,兰州730000

出　　处：《实用医学杂志》2022年第9期1125-1129,共5页The Journal of Practical Medicine

基　　金：甘肃省科技计划项目(创新基地和人才计划)(编号:20JR5RA618)。

摘　　要：目的分析CT引导下胸腔引流微管对肺气肿合并巨大肺大疱患者的临床疗效及安全性。方法选择肺气肿合并巨大肺大疱患者74例,其中胸腔镜手术30例(对照组),胸腔引流微管44例(观察组)。比较两组患者手术时间、出血量、切口感染、术后引流时间、术后住院时间、带管时间和肺复张时间,术后1 d、3 d和7 d疼痛视觉模拟量表(VAS)评分,肺大疱消失时间和复发率。术前和术后2 d C反应蛋白(CRP)和白细胞介素-6(IL-6)水平,术前和术后1 d动脉血氧分压(PaO_(2))、末梢血氧饱和度(SaO_(2))和第一秒用力呼气量(FEV1)。结果观察组手术时间、术后住院时间和肺复张时间比对照组缩短,带管时间比对照组延长,出血量减少,术后1 d、3 d疼痛VAS评分均低于对照组,术后血清CRP和IL-6水平低于对照组,术后PaO_(2)、SaO_(2)和FEV1均高于对照组(P<0.05)。结论CT引导下胸腔引流微管置入治疗肺气肿合并巨大肺大疱有较好的临床疗效和安全性,比胸腔镜切除术创伤更小、疼痛和炎症反应更轻、肺功能改善更佳。Objective To analyze the clinical efficacy and safety of CT-guided thoracic drainage microtubule for patients of emphysema complicated with giant pulmonary bullae.Methods A total of 74 patients of emphysema with giant pulmonary bullae into our hospitalwerechosed.As the control group,30 patients underwent surgical thoracoscopic surgery,while the observation group included 44 patients who underwent CT-guided placement of thoracic drainage microtubules.The operation indexes between the two groups were compared,including operation time,bleeding volume,incision infection,postoperative drainage time,postoperative stay-in hospital days,tube time and lung re-expansion time,pain visual analogue scale(VAS)score 1 d,3 d and 7 d after operation,disappearance time and recurrence rate of giant pulmonary bullae.The levels of serum inflammatoryfactors C-reactive protein(CRP)and interleukin-6(IL-6)before and 2 d after operation,as well as arterial partial pressure(PaO_(2)),peripheral oxygen saturation(SaO_(2))and forced expiratory volume in the first second(FEV1)before and 1 d after operation.Results The observation group s operation time,hospital stay days,and lung re-expansion time were shorter than the control group’s,tube time was longer,bleeding volume was less,pain VAS scores 1 d,3 d after operation were lower than the control group,serum CRP and IL-6 levels were lower,and postoperative PaO_(2),SaO_(2),and FEV1 were higher(P<0.05).Conclusion CT-guided thoracic drainage microtubule placement improves clinical efficacy and safety in emphysema with giant pulmonary bullae.It causes less trauma,less pain and inflammation,and improves pulmonary function more than thoracoscopic resection.

关 键 词：肺气肿 肺大疱 胸腔引流微管 胸腔镜手术 肺功能 

分 类 号：R655.3[医药卫生—外科学]