胸膜摩擦联合滑石粉固定在肺大疱微创切除术的应用效果

Effect of Pleura Friction Combined with Talcum Powder in the Treatment of Pulmonary Bullae

目的探究胸膜摩擦联合滑石粉固定对肺大疱微创切除术的临床效果。方法回顾性分析2014年11月至2016年11月于香河县人民医院接受肺大疱微创切除术治疗的210例肺大疱自发性气胸患者的临床资料,将患者分为3组,各70例。胸膜摩擦组术中采用胸膜摩擦固定,滑石粉组术中采用滑石粉固定,联合组术中采用胸膜摩擦联合滑石粉固定,比较3组效果。结果联合组手术时间显著短于滑石粉组和胸膜摩擦组[(43.22±6.13)min比(53.62±8.32)min,(54.25±8.62)min](P<0.05);胸膜摩擦组住院时间显著长于联合组和滑石粉组[(7.02±1.75)d比(5.13±1.70)d,(5.62±1.46)d](P<0.05);3组术后插管时间比较差异无统计学意义(P>0.05);滑石粉组镇痛药物使用频率显著高于胸膜摩擦组和联合组[(4.61±0.89)次/例比(2.57±0.45)次/例,(2.68±0.52)次/例](P<0.05)。3组肺炎、肺不张发生率比较差异无统计学意义(P>0.05);滑石粉组高热发生率显著高于胸膜摩擦组和联合组[72.9%(51/70)比44.3%(31/70),45.7%(32/70)](P<0.05);胸膜摩擦组胸部残腔发生率显著高于联合组和滑石粉组[15.7%(11/70)比2.9%(2/70)、4.3%(3/70)](P<0.05)。结论在肺大疱微创切除术中采用胸膜摩擦联合滑石粉固定治疗能够有效缩短手术时间,减轻患者疼痛,促进术后康复,控制相关并发症发生,效果良好。

Objective To explore the clinical effect of pleura friction combined with talcum on pulmonary bulla mini- mally invasive resection. Methods Data of 210 cases treated with minimally invasive resection of pulmonary bullae were retrospectively analyzed from Nov. 2014 to Nov. 2016 in Xianghe County People＇s Hospital. The patients were divided into three groups：pleural friction group fixed by pleural friction, talcum powder group fixed by talcum powder, and the combina- tion group fixed by pleural friction combined with talcum powder, and the effect of the three groups was compared. Results The duration of the combination group was significantly shorter than that of the talcum powder group and the pleural friction group [ （43.22 ± 6. 13 ） min vs （ 53.62 ± 8. 32） min, （ 54. 25±8.62） min ] （ P 〈 0. 05 ） ; the hospitalization time of the pleural friction group was significantly longer than that of the combination group and the talcum powder group [ （7.02 ± 1.75） d vs （5. 13 ± 1.70） d, （5.62 ± 1.46） d] （P 〈0. 05） ; The operative time of the three groups had no statistically significant difference （P 〉 0.05 ） ; Talcum powder group had a significantly higher analgesic drug use frequency than the pleural friction group and combination group [ （ 4. 61 ± 0. 89 ） times/case vs （ 2. 57 ± 0. 45 ） times/case, （ 2. 68 ±0. 52） times/case ] （P 〈 0. 05 ） ;there was no significant difference in the incidence of pneumonia and atelectasis between the three groups （ P 〉 0. 05 ） ; the incidence of high heat in the talcum powder group was significantly higher than that of the pleural friction group and the combination group[72. 9% （51/70） vs 44. 3% （31/70） ,45.7% （32/70） ] （P 〈0. 05） ; the incidence of the chest cavity in the pleural friction group was significantly higher than those of the combination group and talcum powder group[ 15. 7% （11/70） vs 2. 9% （2/70） ,4. 3% （3/70） ] （P 〈0. 05）. Conclusion The use of the pleural friction combined with talcum powder in the pneumosis is effective in shortening the operation time and can reduce the patient pain, promote the postoperative rehabilitation, and eontrel the related complications with good effect.