两种不同生物学制剂在肺大疱减容术中的应用效果比较

Comparative analysis of effect of two kinds of biological agents in volume-reduced bullae

目的：回顾分析两种不同生物学制剂在肺大疱减容术中的应用效果。方法11例肺大疱患者均在大型C臂机适时引导下经超细支气管镜工作通道先后通过微导管向目标细支气管注入生物学制剂。所有患者随机分成两组，A组（7例）选用纤维蛋白原＋凝血酶稀释液，B组（4例）选用猪源蛋白粘合剂。 A组采用通过超细支气管镜置入外径＜1．2 mm 微导管，依次注入利多卡因2 mL、纤维蛋白原5 mL、凝血酶（500 u ×2支）稀释液。 B组则以相同方法注入猪源蛋白粘合剂，注药完毕后吸尽支气管近端混悬残留液。两组均记录操作时间，并对临床疗效及并发症进行比较。结果 A组操作时间为5～15 min，B组操作时间为6～20 min。综合两组：完全有效4例，明显有效2例，基本有效3例，完全无效2例，总有效率81．82％（9/11）。 A、B两组一般并发症发生率分别为52．38％（22/42）、58．33％（14/24），差异无统计学意义（χ2＝0.22，P＞0．05），而且两组均无严重并发症的发生。结论两种不同生物学制剂安全性及有效性可能均较好，但考虑到样本量较少，尚需进一步建立对照组、扩大病例数进行验证。

Objective To retrospectively analyze the effect of two kinds of biological agents in volume -re-duced bullae .Methods 11 patients who suffered from bullae were operated under large C-arm locating ,and infused two kinds of biological agents through micro catheter of fibreoptic bronchoscopy .All of them were randomly divided into the two groups .The biological agents in group A were fibrinogen and diluent thrombin , and that of group B was Porcine Fibrin Sealant Kit .In group A,the micro catheter with diameter of micro thread less than 1.2mm was placed in bullae through fibreoptic bronchoscope ,and then the 2mL lidocaine,5 ml fibrinogen,and double of 500u diluent thrombin were inproperorder injected through micro catheter .In group B,the Porcine Fibrin Sealant Kit was injected at the same method,and then the suspension fluid was exacted .The operation time was recorded ,and then the clinical efficacy and incidence rate of complications were compared .Results The operation time of group A was 5-15 minutes, and that of group B was 6-20 minutes.For all the patients ,4 cases were totally effective ,2 cases were significantly effective,and 2 cases were totally non-effective.The total effective rate was 81.82%（9/11）.The incidence rates of common complications in group A and B were 52.38%（22/42）,58.33%（14/24）,respectively,the difference was not significant （χ2 =0.22,P〉0.05）.Moreover,there were no serious complications in all cases .Conclusion The security and effect of two kinds of biological agents might be well enough ,but in view of less cases ,they were worth to further popularized and applied in clinical practice .