高渗葡萄糖胸腔内灌注治疗难治性自发性气胸的临床价值  

Clinical value of hypertonic glucose intrapleural perfusion in the treatment of refractory spontaneous pneumothorax

作　　者：黄壮伟 麦伟豪 吴格怡 HUANG Zhuangwei;MAI Weihao;WU Geyi(Department of Respiratory Medicine,the Second Affiliated Hospital of Guangdong Medical University,Guangdong,Zhanjiang 524000,China)

机构地区：[1]广东医科大学附属第二医院呼吸内科,广东湛江524000

出　　处：《中国医药科学》2022年第15期174-177,共4页China Medicine And Pharmacy

基　　金：广东省湛江市科技计划项目(2020B102)。

摘　　要：目的 探讨高渗葡萄糖胸腔内灌注治疗难治性自发性气胸的临床价值。方法 选择2020年1—7月广东医科大学附属第二医院呼吸内科收治的难治性自发性气胸患者80例为研究对象。按照随机数字表法分为观察组和对照组,每组各40例。观察组使用预混合50%葡萄糖溶液逆行胸腔灌注,对照组则注入稀释滑石粉逆行胸腔灌注,比较两组术后24 h机体致痛物质水平、术中操作时间及术后6 h疼痛程度,统计两组术后肺功能恢复正常比例及随访1年复发率。结果 术后24 h,观察组机体致痛物质人血清P物质(SP)和神经肽(NPY)水平均显著低于对照组,差异有统计学意义(P <0.05),观察组术中操作时间短于对照组,差异有统计学意义(P <0.05),术后6 h疼痛程度低于对照组,差异有统计学意义(P <0.05),观察组术后肺功能恢复正常比例高于对照组,随访1年复发率低于对照组,差异有统计学意义(P <0.05)。结论 针对难治性自发性气胸患者,应用高渗葡萄糖灌注,可有效降低机体致痛物质水平,患者恢复快,治疗后复发率低。Objective To investigate the clinical value of hypertonic glucose intrapleural perfusion in the treatment of refractory spontaneous pneumothorax. Methods A total of 80 patients with refractory spontaneous pneumothorax admitted to and treated in the Department of Respiratory Medicine of the Second Affiliated Hospital of Guangdong Medical University from January to July 2020 were selected as the study subjects.According to the random number table method, they were divided into the observation group(n=40) and the control group(n=40). The observation group was treated with retrograde thoracic perfusion of premixed 50%glucose solution, while the control group was treated with retrograde thoracic perfusion of retrograde infusion of diluted talcum powder. The levels of algetic substances at 24 h after operation in the two groups were compared.And the operation time and pain degree at 6 h after operation in the two groups were compared. The proportions of postoperative pulmonary function recovering and the relapse rates of 1 year follow-up in the two groups were counted. Results At 24 h after operation, the levels of organismic algetic substances of human serum substance P(SP) and neuropeptide(NPY) in the observation group were both significantly lower than those in the control group, with statistically significant differences(P < 0.05). The operation time of treatment in the observation group was shorter than that in the control group, with statistically significant difference(P < 0.05). The pain degree at 6 h after operation in the observation group was lower than that in the control group, with statistically significant difference(P < 0.05). After operation, the proportion of pulmonary function in the observation group recovered to normal was higher than that in the control group, and the relapse rate of 1 year follow-up was lower than that in the control group, with statistically significant differences(P < 0.05). Conclusion For patients with refractory spontaneous pneumothorax, the application of hypertonic glucose

关 键 词：高渗葡萄糖 胸腔 逆行灌注 难治性 自发性气胸 

分 类 号：R655[医药卫生—外科学]