| 陆荣国,郑明峰,何毅军,李慧星,毛文君,于 跃.单操作孔电视胸腔镜手术对老年孤立性肺结节患者肺功能和免疫球蛋白的影响[J].,2019,19(24):4707-4710 |
| 单操作孔电视胸腔镜手术对老年孤立性肺结节患者肺功能和免疫球蛋白的影响 |
| Effect of Single-hole Video-assisted Thoracoscopic Surgery on Pulmonary Function and Immunoglobulin in Elderly Patients with Solitary Pulmonary Nodules |
| 投稿时间：2019-06-07 修订日期：2019-06-30 |
| DOI：10.13241/j.cnki.pmb.2019.24.024 |
| 中文关键词: 单操作孔 电视胸腔镜手术 老年 孤立性肺结节 肺功能 免疫球蛋白 |
| 英文关键词: Single-hole Video-assisted thoracoscopic surgery Elderly Solitary pulmonary nodules Pulmonary function Immunoglobulin |
| 基金项目:江苏省卫生和计划生育委员会科研项目（BJ161002） |
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| 中文摘要: |
| 摘要 目的：探讨单操作孔电视胸腔镜手术（VATS）对老年孤立性肺结节（SPN）患者肺功能和免疫球蛋白的影响。方法：回顾性分析2016年2月~2019年1月期间南京医科大学附属无锡人民医院收治的78例老年SPN患者的临床资料。根据手术方式的不同将患者分为对照组（n=43）和研究组（n=35），对照组给予传统多孔VATS肺结节切除术治疗，研究组给予单操作孔VATS肺结节切除术治疗，比较两组患者临床指标、肺功能、免疫球蛋白、视觉疼痛模拟评分量表（VAS）、并发症以及复发情况。结果：两组手术时间比较无差异（P>0.05），研究组住院时间短于对照组，术后引流量、住院费用、术中出血量均少于对照组（P<0.05）。两组均未见严重的并发症，且两组均无复发病例。两组术后1个月第1 s用力呼气容积（FEV1）、每分钟最大通气量（MVV）、用力肺活量（FVC）均下降，但研究组高于对照组（P<0.05）。两组术后3 d免疫球蛋白A（IgA）、免疫球蛋白M（IgM）、免疫球蛋白G（IgG）均下降，但研究组高于对照组（P<0.05）。术后1 d、3 d、5 d研究组VAS评分较对照组降低（P<0.05）。结论：单操作孔VATS治疗老年SPN，可有效改善围术期指标，提高免疫力，减轻肺功能损伤，且安全性较好，临床应用价值较高。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effect of single-hole video-assisted thoracoscopic surgery (VATS) on pulmonary function and immunoglobulin in elderly patients with solitary pulmonary nodules. Methods: The clinical data of 78 elderly patients with SPN who were admitted to Wuxi People's Hospital Affiliated to Nanjing Medical University from February 2016 to January 2019 were retrospectively selected. The patients were divided into control group (n=43) and study group (n=35) according to different surgical methods. The control group was treated with traditional porous VATS pulmonary nodule resection, while the study group was treated with single-hole VATS pulmonary nodule resection. The clinical indicators, pulmonary function, immunoglobulin, visual analogue pain scale (VAS), complications and recurrence were compared between the two groups. Results: There was no difference in operation time between the two groups (P>0.05). The hospitalization time in the study group was shorter than that in the control group. Postoperative drainage, hospitalization expenses and intraoperative bleeding were less than those in the control group (P<0.05). No serious complications were found in both groups, and no recurrence occurred in both groups. The forced expiratory volume (FEV1), maximum ventilation volume per minute (MVV) and forced vital capacity (FVC) of the two groups decreased at the 1st second of 1 month after operation, but those in the study group were higher than those in the control group (P<0.05). Immunoglobulin A (IgA), immunoglobulin M (IgM), and immunoglobulin G (IgG) decreased in both groups at 3 days after operation, but thosel in the study group were higher than those in the control group (P<0.05). The VAS scores of the study group were lower than those of the control group at the 1st, 3rd and 5th day after operation (P<0.05). Conclusion: Single-hole VATS treatment of elderly patients with SPN can effectively improve perioperative indicators, improve immunity, reduce lung function damage, and it has good safety, it has a high clinical value. |
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