胸腔镜肺大泡切除术对肺大泡患者并发症的影响

The Influence of Thoracoscopic Bullaeectomy on the Complications of Patients with Pulmonary Bullae

摘要:

〔摘 要〕 目的：探讨胸腔镜肺大泡切除术治疗肺大泡对患者机体应激反应及术后并发症的临床影响。方法：选取 2016 年 7 至 2020 年 7 月东莞市东南部中心医院收治的 52 例肺大泡患者作为研究对象，按治疗方式的不同将其分为常规组（行单纯 闭式引流治疗）和研究组（行胸腔镜肺大泡切除术治疗），每组 26 例。比较两组引流管留置时间、手术时间、术后疼痛评 分、生活质量综合评定问卷（GQOL–74）评分和术后皮质醇（Cor）、去甲肾上腺素（NE）、血管紧张素Ⅱ（Ang Ⅱ）水 平，以及并发症发生率。结果：治疗后，研究组患者引流管留置时间、手术时间均短于常规组，术后疼痛评分低于常规组， 而 GQOL–74 评分高于常规组，差异具有统计学意义（P ＜ 0.05）；治疗后，研究组患者 Cor、NE、Ang Ⅱ水平均低于常规 组，差异具有统计学意义（P ＜ 0.05）；研究组患者不良反应发生率为 3.85 %，显著低于常规组的 23.08 %，差异具有统计 学意义（P ＜ 0.05）。结论：采用胸腔镜肺大泡切除术治疗肺大泡，能缩短手术时间、引流管留置时间，降低手术应激反应， 减轻疼痛，术后并发症发生率低，有利于患者病情恢复。

Abstract:

〔Abstract〕 Objective To investigate the clinical effects of thoracoscopic bullaeectomy for pulmonary bullae on patients' body stress response and postoperative complications. Methods 52 patients with pulmonary bullae who were admitted to the Southeast Central Hospital of Dongguan from July 2016 to July 2020 were selected as the research objects. According to the different treatment methods, they were divided into the conventional group (simple closed drainage treatment) and the study Group (treatment with thoracoscopic bullaeectomy), 26 cases in each group. Comparison of drainage tube indwelling time, operation time, postoperative pain score, quality of life comprehensive assessment questionnaire (GQOL–74) score, postoperative cortisol (Cor), norepinephrine (NE), and angiotensin II (Ang II) were compared between the two groups ) Level, and complication rate. Results After treatment, the drainage tube indwelling time and operation time of the study group were shorter than those of the conventional group, the postoperative pain score was lower than that of the conventional group, and the GQOL-74 score was higher than that of the conventional group, the difference was statistically significant (P < 0.05) After treatment, the levels of Cor, NE and AngⅡ in the study group were lower than those in the conventional group, and the difference was statistically significant (P < 0.05); the adverse reaction rate of the study group was 3.85%, which was significantly lower than 23.08% in the conventional group. The difference was statistically significant (P < 0.05). Conclusion The use of thoracoscopic bullaeectomy for the treatment of pulmonary bullae can shorten the operation time, the drainage tube indwelling time, reduce the surgical stress response, relieve pain, and reduce the incidence of postoperative complications, which is very conducive to the recovery of patients.