选择性支气管封堵术治疗难治性气胸的疗效分析  

Efficacy of selective bronchial occlusion in the treatment of intractable pneumothorax

作　　者：林连顺 陈晓阳[1] 张华平[1] 陈云峰[1] 张祎祥[1] 曾奕明[1] Lin Lianshun;Chen Xiaoyang;Zhang Huaping;Chen Yunfeng;Zhang Yixiang;Zeng Yiming(Department of Respiratory and Critical Care medicine,the Second Affiliated Hospital of Fujian Medical University,Fujian Respiratory Medicine Center,Fujian Clinical Research Center for Interventional Diagnosis and Treatment of Respiratory Diseases,Quanzhou 362000,China)

机构地区：[1]福建医科大学附属第二医院呼吸与危重症医学科,福建省呼吸医学中心,福建省呼吸疾病介入诊治临床研究中心,泉州362000

出　　处：《中华医学杂志》2022年第44期3501-3504,共4页National Medical Journal of China

基　　金：国家自然科学基金(82070021)。

摘　　要：目的分析选择性支气管封堵术(SBO)对难治性气胸的治疗效果。方法将2019年1月1日至2021年12月31日福建医科大学附属第二医院呼吸与危重症医学科收治的86例接受SBO治疗的难治性气胸患者纳入研究。基于患者的住院病历收集并分析患者的基本情况和诊治情况。结果研究对象年龄为(62±11)岁,其中男性83例(96.5%)。首次SBO治愈率为30.2%(26/86);首次SBO治疗有效率为38.4%(33/86),SBO最终治愈率为59.3%(51/86);SBO联合其他方法治疗的总治愈率为73.3%(63/86)。SBO治愈患者由首次封堵至完全停止漏气时间的M(Q_(1),Q_(3))为6.5(3,7)d,短于SBO术后最终拔管患者[11(7,19)d](H=30.24,P<0.001)。首次SBO治愈患者住院天数的M(Q_(1),Q_(3))为19(14,25)d,短于全部患者[28(19,37)d](H=12.89,P=0.002)。首次SBO治愈、SBO治疗有效和无效患者住院费用的M(Q_(1),Q_(3))分别为23187(18906,27798)、41580(29388,50762)和38462(27542,51720)元,差异具有统计学意义(H=18.58,P<0.001)。SBO术后并发症发生率为7.59%(11/145)。结论SBO对难治性气胸具有良好的疗效且安全性较高。Objective To analyze the effect of selective bronchial occlusion(SBO)in the treatment of intractable pneumothorax.Methods A total of 86 patients with refractory pneumothorax treated with SBO in the Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Fujian Medical University from January 1,2019 to December 31,2021 were included in this study.The basic information,diagnosis and treatment of the patients were collected and analyzed based on their inpatient records.Results The age of the subjects was(62±11)years old,and 83 cases(96.5%)were male.The first time SBO cure rate was 30.2%(26/86).The effective rate of the first time SBO treatment was 38.4%(33/86),and the final cure rate of SBO was 59.3%(51/86).The total cure rate of SBO combined with other therapies was 73.3%(63/86).The median time[M(Q_(1),Q_(3))]from the first plugging to the complete cessation of air leakage in SBO cured patients was 6.5(3,7)days,which was shorter than that in the final extubation patients after SBO[11(7,19)days](H=30.24,P<0.001).The median[M(Q_(1),Q_(3))]length of hospital stay of the first SBO cured patients was 19(14,25)days,which was shorter than that of all patients[28(19,37)days](H=12.89,P=0.002).The median[M(Q_(1),Q_(3))]hospitalization expenses of patients with first SBO cure,effective SBO treatment and ineffective SBO treatment were 23187(18906,27798),41580(29388,50762)and 38462(27542,51720)yuan,respectively,and the difference was statistically significant(H=18.58,P<0.001).The incidence of complications after SBO was 7.59%(11/145).Conclusion SBO has good efficacy and relative high safety in the treatment of intractable pneumothorax.

关 键 词：气胸 治疗结果 疗效比较研究 选择性支气管封堵术 回顾性病例系列研究 

分 类 号：R561.4[医药卫生—呼吸系统]