肺结核行胸腔镜下单孔肺叶切除术的疗效分析

Analysis of curative Effect of single-hole Lobectomy under Thoracoscope for pulmonary Tuberculosis

目的探究胸腔镜下单孔肺叶切除术治疗肺结核的应用价值。方法选取2019年5月至2021年5月信阳市第五人民医院收治的肺结核患者中选取85例自愿接受手术的患者,根据患者行胸腔镜下单孔和多孔肺叶切除术的不同分为单孔组(43例)和多孔组(42例),比较两组临床效果。结果两组术中出血量、术后引流管留置时间、术后24 h引流量、住院时间比较,差异无统计学意义(P>0.05)。单孔组手术时间长于多孔组;术后2 h,单孔组患者炎症各指标因子水平均低于多孔组;术后3 d,两组患者各炎症因子水平均较术后2 h显著降低,且单孔组低于多孔组;术后,两组患者静息时和咳嗽时疼痛度评分均随时间延长逐渐降低,且单孔组较多孔组更低;单孔组术后并发症发生率为6.98%,显著低于多孔组23.81%,差异有统计学意义(P<0.05)。结论胸腔镜下单孔肺叶切除术能减轻患者术后疼痛度,降低并发症发生率,且对患者炎症因子水平与术后恢复有积极影响。

Objective To explore the application value of single-hole lobectomy under thoracoscope in the treatment of pulmonary tuberculosis.Methods From May 2019 to May 2021,85 patients with pulmonary tuberculosis admitted to the hospital who volunteered to undergo surgery were divided into a single-hole group(43 cases)and a multi-hole group(42 cases)according to the difference between single-hole and multi-hole lobectomy under thoracoscopy.The clinical effects of the two groups were compared.Results There was no statistically significant difference between the two groups in terms of intraoperative bleeding volume,postoperative drainage tube retention time,postoperative drainage flow rate at 24 hours,and hospitalization time(P>0.05).The surgical time of the single-hole group was longer than that of the multi-hole group;At 2 hours after surgery,the levels of inflammatory cytokines in the single-hole group were lower than those in the multi-hole group;On the 3rd day after surgery,the levels of various inflammatory factors in both groups of patients were significantly reduced compared to the 2nd hour after surgery,and the single-well group was lower than the multi-hole group;After surgery,the pain scores during rest and coughing gradually decreased with time in both groups of patients,and the single-hole group was lower than the multi-hole group;The incidence of postoperative complications in the single-hole group was 6.98%,significantly lower than that in the multi-hole group(23.81%),with a statistically significant difference(P<0.05).Conclusions Single-hole lobectomy under Thoracoscopy can reduce postoperative pain,reduce the incidence of complications,and has a positive impact on the level of inflammatory factors and postoperative recovery.