不同胸腔镜膜纤维板切除术治疗包裹性胸腔积液的疗效比较  

Comparison of the efficacy of different thoracoscopic membrane fiborboard resections for the treatment of encapsulated pleural effusions

作　　者：梁葳[1] 陈凯[1] 张文静 LIANG Wei;CHEN Kai;ZHANG Wen-jing(Department of Cardiothoracic Surgery,The First Affiliated Hospital of Guangdong Pharmaceutical University,Guangzhou 510080,China)

机构地区：[1]广东药科大学附属第一医院心胸外科,广州510080

出　　处：《中国处方药》2023年第5期144-147,共4页Journal of China Prescription Drug

摘　　要：目的 探讨不同胸腔镜膜纤维板切除术治疗包裹性胸腔积液的疗效。方法 以某院2019年4月~2022年4月收治的55例患者为研究对象,以手术方法分为单孔胸腔镜组(20例)、双孔胸腔镜组(18例)、开胸手术组(17例),对比三组临床指标变化,并发症发生率等。结果 三组治疗有效率差异无统计学意义(P>0.05)。单孔胸腔镜组术后肺不张、漏气、胸腔积液、切口感染等并发症发生率均低于双孔腹腔镜组和开放手术组,组间差异有统计学意义(P<0.05)。单孔胸腔镜患者术后血肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)与白细胞介素-8(IL-8)水平均低于双孔胸腔镜和开放手术组,差异有统计学意义(P<0.05)。三组术后1个月的第1秒用力呼气容积(FEV1)、第1秒用力呼气容积/用力肺活量(FEV1/FVC)与呼气流量峰值(PEF)均高于术前,差异有统计学意义(P<0.05)。结论 相比双孔胸腔镜手术与传统开放手术而言,单孔胸腔镜手术具有更多的临床优势,在并发症改善上具有良好效果。Objective To investigate the efficacy of different thoracoscopic membrane fiborboard resections for the treatment of encapsulated pleural effusions.Methods Fifty-five patients admitted to our hospital from April 2019 to April 2022 were studied and divided into single-port thoracoscopic group(20 cases),double-port thoracoscopic group(18 cases),and open-chest surgery group(17 cases)by surgical method,and the changes of clinical indexes and complication rates of the three groups were compared.Results There was no significant difference in the effective rate among the three groups(P>0.05).The incidence of postoperative complications such as atelectasis,air leakage,pleural effusion,and incision infection in the single-port thoracoscopic group was lower than that in the double-port thoracoscopic group and the open surgery group,and the differences between the groups were statistically significant(P<0.05).The blood levels of TNF-α,CRP and IL-8 in patients with single-port thoracoscopic surgery were lower than those in double-port thoracoscopic and open-chest surgery groups,and the differences were statistically significant(P<0.05).The FEV1,FEV1/FVC and PEF at 1 month after operation in the three groups were all higher than those before operation,and the differences were statistically significant(P<0.05).Conclusion Compared with double-port thoracoscopic surgery and traditional open surgery,single-port thoracoscopic surgery has more clinical advantages,and has a good effect on improving complications.

关 键 词：单孔胸腔镜 双孔胸腔镜 包裹性胸腔积液 

分 类 号：R655[医药卫生—外科学]