荧光染色法与膨胀萎陷法用于胸腔镜肺结核肺段切除术的临床对比研究  

Comparative study of fluorescence staining method and inflation-deflation method for thoracoscopic pulmonary tuberculosis segmentectomy

作　　者：龚胜 王宁 李丹 李刚 刘玉 蒋良双 姚晓军 Gong Sheng;Wang Ning;Li Dan;Li Gang;Liu Yu;Jiang Liangshuang;Yao Xiaojun(Department of Thoracic Surgery,Public Health Clinical Center of Chengdu,Chengdu 610061,China)

机构地区：[1]成都市公共卫生临床医疗中心胸外科,成都610061

出　　处：《中国防痨杂志》2025年第3期292-297,共6页Chinese Journal of Antituberculosis

基　　金：四川省重点研发项目(2023YFG0283);四川省临床重点专科建设项目(2024AXWKP001);成都市临床重点专科建设项目(20240117)。

摘　　要：目的:对比分析荧光染色法与膨胀萎陷法在肺结核胸腔镜肺段切除术中的临床价值。方法:采用回顾性研究方法,收集2021年1月至2024年5月在成都市公共卫生临床医疗中心行胸腔镜肺段切除术的96例肺结核患者临床资料,按照段间平面确定方式将患者分为荧光染色组(63例)和膨胀萎陷组(33例)。对比分析两组判定段间平面的时间、手术时长、术中出血量,以及术后引流时间、术后住院日和并发症发生率等方面的差异。结果:荧光染色组判定段间平面的时间[(28.98±9.32)s]明显短于膨胀萎陷组[(1077.56±194.00)s],差异有统计学意义(t=-42.656,P<0.001);但手术时长[(141.32±67.50)min]、术中出血量[100(50,200)ml]、术后引流时间[(7.08±4.24)d]、术后住院日[(10.73±4.32)d]、术后并发症的发生率[23.81%(15/63)]与膨胀萎陷组[分别为(129.24±61.70)min、100(50,100)ml、(7.21±3.06)d、(9.55±4.15)d、12.12%(4/33)]的差异均无统计学意义(t=-0.857,P=0.394;Z=-0.973,P=0.334;t=0.159,P=0.874;t=-1.293,P=0.199;χ2=1.864,P=0.172)。结论:荧光染色显影技术可快捷、精准地判断肺结核胸腔镜肺段切除术中的段间平面,且未增加术中出血量、手术时间、术后引流时间、住院日及并发症,具有安全、有效、可行的特点,值得临床参考推广。Objective:To compare and analyze the clinical efficacy of fluorescence staining method and inflation-deflation method in thoracoscopic pulmonary tuberculosis(PTB)segmentectomy.Methods:Clinical data of 96 PTB patients who underwent thoracoscopic pulmonary segmentectomy at Department of Thoracic Surgery,Public Health Clinical Center of Chengdu from January 2021 to May 2024 were retrospectively collected.The patients were divided into a fluorescence staining group(63 cases)and an inflation-deflation group(33 cases)according to the method in determining the intersegment.We compared and analyzed the differences in the time to determine the intersegmental plane,surgical duration,intraoperative blood loss,postoperative drainage time,postoperative hospital stay duration,and incidence of postoperative complications between the two groups.Results:The time to determine the intersegmental plane in the fluorescence staining group((28.98±9.32)s)was significantly shorter than that in the inflation-deflation group((1077.56±194.00)s),with statistically significance(t=-42.656,P<0.001).However,there was no statistically significant difference in surgical duration((141.32±67.50)min),intraoperative blood loss(100(50,200)ml),postoperative drainage time((7.08±4.24)d),postoperative hospital stay((10.73±4.32)d),postoperative complication rate(23.81%(15/63))in the fluorescence staining group compared to the inflation-deflation group((129.24±61.70)min,100(50,100)ml,(7.21±3.06)d,(9.55±4.15)d,12.12%(4/33),respectively)(t=-0.857,P=0.394;Z=-0.973,P=0.334;t=0.159,P=0.874;t=1.293,P=0.199;χ2=1.864,P=0.172).Conclusion:The fluorescence staining thoracoscopy technology is safe and effective in determine the intersegment plane during thoracoscopic segmentectomy for PTB without increasing intraoperative blood loss,surgical time,postoperative drainage time,hospital stay time,or complications.This technology is worthy of clinical reference and promotion.

关 键 词：结核 肺 肺切除术 胸腔镜 荧光X线摄影术 萎陷疗法 

分 类 号：R521[医药卫生—内科学] R605[医药卫生—临床医学]