胸腔内注射凝血酶联合引流管悬吊治疗难治性气胸的临床疗效  

Clinical efficacy of intrapleural injection of thrombin combined with drainage tube suspension in the treatment of refractory pneumothorax

作　　者：张忠强[1] 胡丽丽 陈俊丽 ZHANG Zhongqiang;HU Lili;CHEN Junli(Department of Thoracic Surgery,the First Hospital of Handan,Handan Hebei 056001,China)

机构地区：[1]邯郸市第一医院胸外科,河北邯郸056001

出　　处：《中国急救复苏与灾害医学杂志》2024年第7期914-917,共4页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：邯郸市科学技术局项目(课题编号:22422083045ZC)。

摘　　要：目的观察胸腔内注射凝血酶联合引流管悬吊治疗难治性气胸的临床疗效。方法纳入2022年5月—2023年5月医院接受胸腔内注射凝血酶联合引流管悬吊治疗的60例难治性气胸患者,作为观察组,并纳入同时期医院接受持续胸腔闭式引流,辅助以持续负压吸引常规内科治疗的52例难治性气胸患者,作为对照组;治疗3周后比较两组临床疗效、临床指标(炎症发生率、肺部感染情况、肺功能障碍发生情况、刺激性咳嗽)、免疫功能指标[成熟T淋巴细胞(CD_(3)^(+))、指诱导性T细胞/辅助性T细胞(CD_(4)^(+))、抑制性T细胞/细胞毒性T细胞(CD_(8)^(+))]以及药物不良反应的发生情况。结果治疗3周后,观察组和对照组总有效率分别为96.67%(58/60)和82.69%(43/52),差异有统计学意义(P<0.05)。治疗3周后,观察组和对照组的临床指标(炎症发生率、肺部感染情况、肺功能障碍发生情况、刺激性咳嗽)有所好转,且观察组优于对照组,差异具有统计学意义(P<0.05)。治疗3周后,观察组和的对照组的CD_(3)^(+)分别为(1 890.39±172.45)、(860.11±93.64)μL;观察组和的对照组的CD_(4)^(+)分别为(900.63±94.13)、(478.17±50.74)μL;观察组和的对照组的CD_(8)^(+)分别为(800.41±84.35)、(330.42±30.86)μL,差异具有统计学意义(P<0.05)。对照组和观察组治疗期间均无不良反应,差异无统计学意义(P>0.05)。结论胸腔内注射凝血酶联合引流管悬吊治疗难治性气胸有良好的临床疗效,且治愈率较高。Objective To observe the clinical effect of intrathoracic thrombin injection combined with drainage tube suspension in the treatment of refractory pneumothorax.Methods Data of 60 patients with refractory pneumothorax who received intrathoracic thrombin injection combined with drainage tube suspension treatment in the same period were included as the observation group,the data of 52 patients with refractory pneumothorax who received continuous closed thoracic drainage in hospital and were assisted by conventional medical treatment with continuous negative pressure suction during May 2022 to May 2023 were included as the control group.After 3 weeks of treatment,the clinical efficacy,clinical indicators (incidence of inflammation,pulmonary infection,pulmonary dysfunction and irritating cough),immune function indicators[mature T lymphocytes (CD_(3)^(+)),induced T cells/helper T cells (CD_(4)^(+)),inhibitory T cells/cytotoxic T cells (CD_(8)^(+))]and the occurrence of adverse drug reactions were compared between the two groups.Results After 3 weeks of treatment,the total effective rates of the observation group and the control group were 96.67%(58/60) and 82.69%(43/52) respectively (P<0.05).After 3 weeks of treatment,the clinical indexes (incidence of inflammation,pulmonary infection,pulmonary dysfunction and irritating cough) of the observation group and the control group improved,and the difference was statistically significant (P<0.05).After 3 weeks of treatment,the CD_(3)^(+)in the observation group and the control group were (1890.39±172.45)μL and (860.11±93.64)μL,respectively.CD_(4)^(+)in the observation group and the control group were (900.63 94.13)μL and (478.17±50.74)μL,respectively.The CD_(8)^(+)in the observation group and the control group were (800.41±84.35)μL and (330.42±30.86)μL,respectively,with statistical significance (P<0.05).There were no adverse reactions in the control group and the observation group during treatment,and the difference was not statistically significant (P>0.05).Conclu

关 键 词：凝血酶 引流管悬吊 难治性气胸 临床疗效 免疫功能 

分 类 号：R561.4[医药卫生—呼吸系统]