单孔胸腔镜肺大疱切除术治疗原发性自发性气胸的疗效及对肺功能和氧化应激反应的影响

Effect of single-port video-assisted thoracoscopic bullae resection for primary spontaneous pneumothorax and its effect on pulmonary function and oxidative stress response

目的探究单孔胸腔镜肺大疱切除术治疗原发性自发性气胸的疗效及对肺功能和氧化应激反应的影响。方法选取2019年1月至2021年3月河南省南阳市第二人民医院收治的原发性自发性气胸的患者80例,采用随机数字表法分为对照组和观察组,各40例,其中对照组采用传统的三孔胸腔镜肺大疱切除术,观察组行单孔胸腔镜肺大疱切除术,对比两组手术相关指标及疼痛度、肺功能、氧化应激反应相关指标。结果观察组术后拔管时间、住院时间均短于对照组,术中出血量及术后引流量少于对照组,疼痛度评分小于对照组(P<0.05);观察组手术用时较对照组长(P<0.05)。术后1 d,两组患者血清中超氧化物歧化酶(SOD)、丙二醛(MDA)水平均较术前明显升高(P<0.05);术后3 d,两组患者血清中SOD、MDA水平较术后1 d明显降低(P<0.05);观察组术后1 d及3 d,血清中SOD、MDA水平均低于对照组(P<0.05)。术后,两组肺功能指标中1 s用力呼气容积(FEV1)、肺活量(FVC)、最大呼气峰流速(PEF)、FEV1/FVC均升高(P<0.05);术后,两组间肺功能比较差异无统计学意义(P>0.05);两组并发症发生率比较差异无统计学意义(P>0.05)。结论原发性自发性气胸患者采用单孔胸腔镜肺大疱切除术治疗的损伤更小,术后恢复快,氧化应激反应及疼痛度轻,且不会增加并发症发生率,对患者肺功能影响较小,具有极高的应用价值。

【Objective】To investigate the effect of single-port video-assisted thoracoscopic bullae resection for primary spontaneous pneumothorax and its effect on pulmonary function and oxidative stress response.【Methods】A total of 80 patients with primary spontaneous pneumothorax admitted to the hospital from January 2019 to March 2021 were selected and divided into control group and observation group by random number table method,with 40 cases in each group.The control group received traditional three-hole thoracoscopic bullae resection,and the observation group received single-hole thoracoscopic bullae resection.Operation-related indexes,pain degree,lung function and oxidative stress response were compared between the two groups.【Results】The postoperative extubation time and hospital stay in the observation group were shorter than those in the control group,the intraoperative blood loss and postoperative drainage volume were less than those in the control group,and the pain score was less than that in the control group(P<0.05).The operation time of the observation group was longer than that of the control group(P<0.05).On day 1 after operation,the levels of SOD and MDA in serum of the two groups were significantly increased compared with those before operation(P<0.05).On postoperative day 3,the levels of SOD and MDA in serum of the two groups were significantly lower than those on postoperative day 1(P<0.05).The levels of SOD and MDA in serum of observation group were lower than those of control group 1 and 3 days after operation(P<0.05).After operation,the lung function indexes of 1 s forced expiratory volume(FEV 1),vital capacity(FVC),maximum peak expiratory flow rate(PEF)and FEV 1/FVC were all increased in the two groups(P<0.05).After surgery,there was no significant difference in lung function between the two groups(P>0.05).There was no statistical significance in the incidence of complications between the two groups(P>0.05).【Conclusion】In patients with primary spontaneous pneumothorax,single-port video-assisted thoracoscopic bullae resection has less injury,faster postoperative recovery,less oxidative stress and pain,and does not increase the incidence of complications.It has less impact on pulmonary function of patients,and has a high application value.