不同胸膜固定术在青年患者单孔胸腔镜肺大疱切除术中应用的效果比较

Efficacy of different procedures of pleurodesis applied to single-port thoracoscopic resection of pulmonary bulla in young patients: a comparative study

目的比较不同胸膜固定方法在青年患者单孔胸腔镜肺大疱切除术中应用的临床效果。方法将60例拟行单孔胸腔镜肺大疱切除术的青年患者分为A、B两组,每组30例。A组采用2%碘酊涂擦行胸膜内固定,B组采用50%高糖喷洒灌注行胸膜内固定。比较两组手术时间、术中出血量、术后胸部疼痛评分、术后带管时间、术后住院时间、术后并发症发生率及术后1年内复发率。结果两组患者在手术时间、术中出血量比较,差异均无统计意义(P>0.05);而B组术后胸部疼痛评分、术后带管时间、术后住院时间及术后并发症发生率均低于或短于A组(均P<0.05)。两组患者术后1年均未复发。结论与应用2%碘酊涂擦胸膜相比,使用50%高糖喷洒灌注行胸膜内固定可减少单孔胸腔镜肺大疱切除术青年患者术后胸痛程度、术后带管时间及术后住院时间,降低术后并发症发生率。

Objective To compare the clinical efficacy of different procedures of pleurodesis applied to single-port thoracoscopic resection of pulmonary bulla in young patients. Methods Sixty young patients scheduled to undergo single-port thoracoscopic resection of pulmonary bulla were divided into group A and group B,with 30 cases in each group. Group A was treated with pleurodesis using 2% iodine for pleura inunction,while group B with pleurodesis using 50% glucose for spray and infusion. The operation duration,intraoperative blood loss,postoperative chest pain score,duration of postoperative catheter indwelling,postoperative hospital stay,incidence rate of postoperative complications,and postoperative 1-year recurrence rate were compared between the two groups. Results There was no significant difference in the operation duration or intraoperative blood loss between the two groups（P〈0. 05）; the postoperative chest pain score,duration of postoperative catheter indwelling,postoperative hospital stay and incidence rate of postoperative complication in group B were lower or shorter than those in group A（all P〈0. 05）. No recurrence cases were observed in the two groups after one year of operation.Conclusion For young patients undergoing single-port thoracoscopic resection of pulmonary bulla,the therapy of spray and infusion with50% glucose applied to pleurodesis can reduce the severity of postoperative chest pain,duration of postoperative catheter indwelling and postoperative hospital stay,compared to the therapy of pleura inunction using 2% iodine applied to pleurodesis,as well as reduce the incidence rate of postoperative complications.