CT引导下OB胶粘堵术在肺大疱治疗中的效果分析  

Analysis of effect of CT-guided OB adhesive occlusion in treatment of pulmonary bullae

作　　者：杨蕴毅 周正[1] 齐景宪[1] YANG Yun-yi;ZHOU Zheng;QI Jing-xian(Department of Respiratory and Critical Care Medicine,the Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院呼吸与危重症医学科,郑州450014

出　　处：《医药论坛杂志》2022年第24期13-17,共5页Journal of Medical Forum

摘　　要：目的探讨CT引导下OB胶粘堵术在肺大疱治疗中的临床疗效,为肺大疱的内科治疗提供依据。方法选取就诊于郑州大学第二附属医院呼吸与危重症医学科的肺大疱患者73名,术前监测患者体温、脉搏、呼吸、血压等生命体征,行胸部CT检查、肺功能检查、6分钟步行距离(6MWD)及圣乔治呼吸问卷(SGRQ)等,然后在CT引导下将OB胶注入肺大疱,术后复查上述检查并行为期1年的随访,观察术后上述指标改善情况及远期预后。结果术后所有患者肺大疱直径均较前缩小,肺功能、血气分析、6MWD、SGRQ指标均较前改善,差异有统计学意义(P<0.05)。术后2个月肺大疱直径(-51.33 cm),术后1年肺大疱直径(-77.26 cm),术后肺功能、血气分析、6MWD、SGRQ:FEV1%(+0.144)、FVC%(+0.097)、MVV%(+0.091)、RV/TLC%(-12.8)、PaO_(2)(+16.55)、PaCO_(2)COPD患者:-8.35、非COPD患者:+4.97、6MWD(+75.3米)及SGRQ(-14.75)。结论CT引导下的OB胶粘堵术对于治疗肺大疱拥有疗效明确、操作简单、创伤小、安全性高、预后良好的优势,是内科治疗肺大疱的有效治疗手段,值得进一步推广。Objective To investigate the clinical effect of CT-guided OB adhesive occlusion in the treatment of pulmonary bullae and to provide a basis for the medical treatment of pulmonary bullae.Methods A total of 73 patients with pulmonary bullae admitted to the Department of Respiratory and Critical Care Medicine of the Second Affiliated Hospital of Zhengzhou University were selected.The vital signs of the patients including temperature pulse,respiration and blood pressure were monitored before operation chest CT examination,pulmonary function examination,6-minute walking distance(6MWD)and St George’s Respiratory Questionnaire(SGRQ)were performed.Then,OB glue was injected into the pulmonary bullae under the guidance of CT,and above-mentioned examinations were reviewed after operation and a 1 year follow-up was performed to evaluate the improvement of the above-mentioned indicators after operation and the long-term prognosis.Results Compared with pre-treatment indicators,the diameter of pulmonary bullae in all patients were reduced,and the 6MWD,pulmonary function and St.George’s score were improved,the differences were statistically significant.The diameter of pulmonary bullae was(-51.33 cm)2 months after surgery and(-77.26 cm)1 year after surgery,After surgery,blood gas analysis,SGRQ and 6MWD showed that FEV1%(+1.44)、FVC%(+9.7)、MVV%(+9.1)、RV/TLC%(-12.8)、PaO_(2)(+16.55)、PaCO_(2)(COPD patients:-8.35、Non COPD patients:+4.97)、6MWD(+75.3 m)and SGRQ(-14.75).Conclusion The clear curative effect,simple operation,less trauma,high safety and good prognosis of CT-guided percutaneous puncture injection of OB adhesive occlusion for the treatment of thoracic pulmonary bullae make it an effective and worth promoting medical treatment.

关 键 词：CT引导下 OB胶粘堵术 肺大疱 

分 类 号：R563[医药卫生—呼吸系统]