全胸腔镜下肺叶切除治疗空洞型肺结核的临床疗效及安全性研究  

Study on the Clinical Efficacy and Safety of Total Thoracoscopic Lobectomy in the Treatment of Cavitary Pulmonary Tuberculosis

作　　者：任廷楷 刘政 刘锋[1] 朱红军[1] REN Ting-kai;LIU Zheng;LIU Feng;ZHU Hong-jun(Department of Thoracic Surgery,Shangqiu First People's Hospital,Shangqiu 476000,Henan Province,China)

机构地区：[1]商丘市第一人民医院胸外科,河南商丘476000

出　　处：《罕少疾病杂志》2024年第3期51-52,55,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的研究全胸腔镜下肺叶切除治疗空洞型肺结核的临床疗效及安全性。方法选择2019年4月-2022年4月于本院胸外科收治的空洞型肺结核124例患者资料进行回顾性分析,根据手术方式将其分为对照组(61例,开胸肺叶切除术)和观察组(63例,全胸腔镜下肺叶切除术),比较两组术前,术后3个月的手术相关指标、肺功能指标中的用力肺活量(FVC)、第1秒用力呼气量(FEV1)、FEV1/FVC、心功能指标中的左心室射血分数(LVEF)、左心室舒张末期直径(LVEDD)以及并发症情况。结果观察组术中出血量少于对照组,手术时间以及住院时间短于对照组(P<0.05);术后,观察组FVC、FEV1、FEV1/FVC、LVEF水平高于对照组,LVEDD水平低于对照组(P<0.05);观察组并发症发生率为4.77%,明显低于对照24.60%(P<0.05)。结论与传统开胸式肺叶切除术相比,全胸腔镜下肺叶切除术能减少空洞型肺结核患者术中出血量,缩短手术及住院所需时间,可以显著改善心肺功能,具有较高的安全性,也是一种可靠的更有利于患者速康复的手术方式。Objective To study the clinical efficacy and safety of total thoracoscopic lobectomy in the treatment of cavitary pulmonary tuberculosis.Methods The data of 124 patients with cavitary pulmonary tuberculosis who were admitted to the Department of Thoracic Surgery of our hospital from April 2019 to April 2022 were selected for retrospective analysis,and according to the operation methods,they were divided into control group(61 cases,thoracotomy lobectomy)and the observation group(63 cases,total thoracoscopic lobectomy),the operation-related indexes,forced vital capacity(FVC)in pulmonary function indexes,forced expiratory volume in 1 second(FEV1),FEV1/FVC,and Left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)in cardiac function indexes and complications were compared between the two groups before surgery and 3 month after surgery.Results The intraoperative blood loss in the observation group was less than that in the control group,and the operation time and hospital stay in the observation group were shorter than those in the control group(P<0.05);after operation,the levels of FVC,FEV1,FEV1/FVC,and LVEF in the observation group were higher than those in the control group,and the level of LVEDD in the observation group was lower than that in the control group(P<0.05);the incidence of complications in the observation group was 4.77%,which was significantly lower than 24.60%of the control group(P<0.05).Conclusion Compared with traditional open chest lobectomy,total thoracoscopic lobectomy can reduce the amount of intraoperative bleeding in patients with cavitary pulmonary tuberculosis,shorten the time required for surgery and hospitalization,significantly improve the cardiopulmonary function,has higher safety,and is also a reliable and more conducive to rapid recovery of patients.

关 键 词：全胸腔镜下肺叶切除 空洞型肺结核 临床疗效 

分 类 号：R521[医药卫生—内科学]