肺段切除术期间采用荧光法对患者心肺功能、免疫功能及安全性的影响  

Effect of fluorescence method on cardiopulmonary function,immune function and safety during pulmonary segmental resection

作　　者：单良 杨光 孔德迁 Shan Liang;Yang Guang;Kong Deqian(Department of Thoracic Surgery,Yucheng People′s Hospital,Yucheng 251200,China)

机构地区：[1]禹城市人民医院胸外科,禹城251200

出　　处：《中国医师进修杂志》2023年第6期548-552,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的探讨肺段切除术期间分别采用荧光法、改良膨胀萎陷法对患者心肺功能、免疫功能及安全性的影响。方法回顾性选择禹城市人民医院2018年3月至2020年8月收治的156例肺段切除术患者,78例患者术中采用荧光法确定段间平面(观察组),78例患者术中采用改良膨胀萎陷法确定段间平面(对照组),比较两组手术各项指标以及术后1和7 d的免疫功能、心肺功能及并发症发生情况。结果观察组手术时间、段间平面出现时间短于对照组[(105.33±10.62)min比(139.46±12.58)min、(15.46±1.13)s比(724.56±65.65)s],差异有统计学意义(P<0.05)。观察组术后1、7 d 6 min步行距离、呼气峰值流速、用力肺活量占预计值百分比、第1秒用力呼气容积占预计值百分比水平均高于对照组[术后1 d:(475.36±10.29)m比(412.11±13.33)m、(284.52±10.33)L/min比(251.13±12.89)L/min、(85.65±3.21)%比(81.13±1.43)%、(83.25±2.55)%比(74.49±2.53)%;术后7 d:(510.23±16.66)m比(488.33±15.42)m、(302.13±15.58)L/min比(285.12±10.22)L/min、(93.46±5.79)%比(88.44±5.44)%、(92.25±2.32)%比(85.54±2.13)%],差异有统计学意义(P<0.05)。观察组术后1、7 d CD4+/CD8+、CD8+、CD4+高于对照组(术后1 d:0.85±0.10比0.52±0.04、0.305±0.025比0.285±0.012、0.325±0.021比0.304±0.025;术后7 d:1.13±0.10比1.02±0.07、0.324±0.029比0.306±0.023、0.359±0.024比0.332±0.025),差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组[2.56%(2/78)比11.54%(9/78)],差异有统计学意义(χ^(2)=4.79,P=0.029)。结论荧光法、改良膨胀萎陷法在肺段切除术中均具有一定效果,但配合荧光法更能够提供可靠技术保障,减轻对患者心肺功能的影响。Objective To explore the effects of fluorescence method and improved expansion and collapse method on cardiopulmonary function,immune function and safety during segmental pneumonectomy.Methods One hundred and fifty-six patients with lung segmental resection operation in Yucheng People′s Hospital from March 2018 to August 2020 were enrolled.They were divided into two groups according to the random number table method,each group with 78 patients.The patients in the observation group were treated with fluorescence method and the patients in the control group were treated with modified expansion collapse method.The operation indexes,immune function and cardiopulmonary function of the two groups were compared,and the incidence of postoperative complications were counted.Results The intraoperative time and the appearance time of intersegmental plane in the observation group were shorter than those in the control group:(105.33±10.62)min vs.(139.46±12.58)min,(15.46±1.13)s vs.(724.56±65.65)s,there were statistical differences(P<0.05).After operative for 1,7 d,the levels of 6 min walking distance,peak expiratory flow rate,percentage of forced vital capacity and percentage forced expiratory volume in 1 second in the observation group were higher than those in the control group:after operative for 1 d:(475.36±10.29)m vs.(412.11±13.33)m,(284.52±10.33)L/min vs.(251.13±12.89)L/min,(85.65±3.21)%vs.(81.13±1.43)%,(83.25±2.55)%vs.(74.49±2.53)%;after operative for 7 d:(510.23±16.66)m vs.(488.33±15.42)m,(302.13±15.58)L/min vs.(285.12±10.22)L/min,(93.46±5.79)%vs.(88.44±5.44)%,(92.25±2.32)%vs.(85.54±2.13)%,there were statistical differences(P<0.05).After operative for 1,7 d,the levels of CD4+/CD8+,CD8+,CD4+in the observation group were higher than those in the control group:after operative for 1 d:0.85±0.10 vs.0.52±0.04,0.305±0.025 vs.0.285±0.012,0.325±0.021 vs.0.304±0.025;after operative for 7 d:1.13±0.10 vs.1.02±0.07,0.324±0.029 vs.0.306±0.023,0.359±0.024 vs.0.332±0.025,there were statistical differe

关 键 词：肺外科手术 肺通气量 荧光法 改良膨胀萎陷法 

分 类 号：R655.3[医药卫生—外科学]