文章摘要
魏周斌,张 俣,阿布都萨拉木·阿尤甫,冯 奇,赵 亮.单孔与两孔胸腔镜下肺大疱切除手术治疗气胸的效果对比[J].,2019,19(22):4316-4319
单孔与两孔胸腔镜下肺大疱切除手术治疗气胸的效果对比
Comparison of the Effect of Single-hole and Two-hole Thoracoscopic Bullae Resection in the Treatment of Pneumothorax
投稿时间:2019-01-27  修订日期:2019-02-24
DOI:10.13241/j.cnki.pmb.2019.22.025
中文关键词: 单孔  两孔  胸腔镜肺大疱切除术  气胸  效果
英文关键词: Single-hole  Two-hole  Thoracoscopic bullae resection  Pneumothorax  Effect
基金项目:新疆维吾尔自治区自然科学基金项目(2015211C162)
作者单位E-mail
魏周斌 新疆医科大学第五附属医院心胸外科 新疆 乌鲁木齐 830000 Weizhoubin9446@126.com 
张 俣 新疆医科大学第五附属医院呼吸科 新疆 乌鲁木齐 830000  
阿布都萨拉木·阿尤甫 新疆医科大学第五附属医院心胸外科 新疆 乌鲁木齐 830000  
冯 奇 新疆医科大学第五附属医院肾病科 新疆 乌鲁木齐 830000  
赵 亮 新疆医科大学第五附属医院心胸外科 新疆 乌鲁木齐 830000  
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中文摘要:
      摘要 目的:对比单孔与两孔胸腔镜下肺大疱切除手术治疗气胸的效果。方法:选取2015年9月~2018年10月我院收治的自发性气胸患者81例,采用随机数字表法将患者分为两组,观察组行单孔胸腔镜下肺大疱切除术,对照组行两孔胸腔镜下肺大疱切除术。比较两组患者的手术相关指标、术后疼痛评分、手术前后血清肿瘤坏死因子-α(Tumor necrosis factor-α, TNF-α)、白细胞介素1β(Interleukin-1β,IL-1β)和C反应蛋白(C-reactive protein,CRP)水平的变化及并发症的发生情况。结果:两组患者的手术时间比较无统计学差异(P>0.05),观察组患者的术中出血量、术后引流量、引流管留置时间和切口长度均显著少于或短于对照组(P<0.05);观察组患者术后3d和术后3个月的视觉模拟评分(Visual analogue scale,VAS)显著低于对照组(P<0.05),两组术后1年VAS评分比较无统计学差异(P>0.05)。术后7d,两组患者的血清TNF-α、IL-1β和CRP水平均较术前显著降低,且观察组显著低于对照组(P<0.05)。两组患者并发症的发生率比较无统计学差异(P>0.05)。结论:与两孔胸腔镜下肺大疱切除术相比,单孔胸腔镜下肺大疱切除术用于气胸患者的创伤更小,更有利于患者术后恢复,且安全性更高。
英文摘要:
      ABSTRACT Objective: To compare the effect of single-hole and two-hole thoracoscopic bullae resection on the pneumothorax. Methods: 81 cases of spontaneous pneumothorax patients admitted to our hospital from September 2015 to October 2018 were selected and divided into two groups by the random number table method. The observation group was given single-hole thoracoscopic bullectomy, and the control group was treated by two-hole thoracoscopic bullectomy. The surgical indicators, postoperative pain scores, changes of the serum TNF-α, IL-1β, and CRP levels before and after surgery, and incidence of complications were compared between the two groups. Results: There was no statistical difference in the operative time between the two groups (P>0.05). The intraoperative blood loss, postoperative drainage volume, drainage tube indwelling time and incision length of observation group were significantly less or shorter than those of the control group (P<0.05). The VAS scores of patients in the observation group were significantly lower than those in the control group at 3 days after surgery and at 3 months after surgery (P<0.05), and there was no statistical difference between the two groups at 1 year after surgery (P>0.05). At 7 days after surgery, the serum levels of TNF-α, IL-1β, and CRP of both groups were significantly lower than those before surgery, which were significantly lower in the observation group than those of the control group(P<0.05). There was no statistical difference in the incidence of complications between the two groups (P>0.05). Conclusion: Compared with two-hole thoracoscopic bullous lung resection, single-hole thoracoscopic bullous lung resection had less invasive for the pneumothorax patients, it was more conducive to postoperative recovery with higher safety.
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