摘要
目的研究全肌肉分离单孔胸腔镜治疗自发性气胸的临床疗效。方法采用回顾性分析方法,以2020年1月至2021年1月入院的90例自发性气胸患者为研究对象,根据治疗方式分为研究组(45例)与对照组(45例);研究组行全肌肉分离单孔胸腔镜治疗,对照组行三孔胸腔镜手术治疗。比较两组术前与术后3 d血气指标[动脉血氧分压(PaO_(2))、动脉血二氧化碳分压(PaCO_(2))]、血清氧化应激指标[丙二醛、超氧化物歧化酶(SOD)]、疼痛介质[血清前列腺素E2(PGE_(2))、P物质(SP)、神经肽Y(NPY)]水平变化与围手术期手术指标(术中出血量、手术时间、胸管引流时间、术后引流量、住院时间)、术后不同时间疼痛评分及并发症发生率。结果术前,两组患者血气指标、血清氧化应激指标、疼痛介质水平比较,差异均无统计学意义(P>0.05)。术后,两组患者PaO_(2)、丙二醛、PGE_(2)、SP、NPY水平均较术前明显升高,PaCO_(2)、SOD水平较术前明显降低,差异均有统计学意义(P<0.05);且研究组PaO_(2)、SOD水平为(83.52±10.86)mmHg、(41.15±6.63)U/mL,高于对照组[(76.19±12.27)mmHg、(36.91±5.37)U/mL],PaCO_(2)、丙二醛为(40.48±8.41)mmHg、(7.69±2.11)nmol/L,低于对照组[(45.97±9.73)mmHg、(9.76±3.08)nmol/L],差异均有统计学意义(P<0.05);研究组PGE_(2)、SP、NRY水平及术中出血量、术后引流量、并发症发生率分别为(162.38±21.26)pg/mL、(1.50±0.27)μg/mL、(119.34±13.11)pg/mL、(26.49±7.57)mL、(128.44±26.75)mL、2.22%,低于对照组[(203.63±25.34)pg/mL、(1.92±0.43)μg/mL、(142.09±15.67)pg/mL、(45.52±10.16)mL、(207.03±41.58)mL、17.78%],手术时间、胸管引流时间、住院时间为(55.62±8.52)min、(2.71±0.24)d、(3.11±0.35)d,均短于对照组[(63.11±10.16)min、(4.11±0.46)d、(4.91±0.56)d],术后6 h、1 d、2 d、3 d疼痛评分均低于对照组,差异均有统计学意义(P<0.05)。结论全肌肉分离单孔胸腔镜治疗自发性气胸的临床疗效优于
Objective To study the effect of total muscle separation single-port thoracoscopy in the treatment of spontaneous pneumothorax.Methods By retrospective analysis,90 patients with spontaneous pneumothorax admitted to hospital from January 2020 to January 2021 were selected as the study subjects,and divided into study group(45 cases)and control group(45 cases)according to treatment methods.The study group received single-port thoracoscopic treatment with whole muscle separation,and the control group received three-port thoracoscopic surgery.Blood gas indexes[arterial partial pressure of oxygen(PaO_(2)),arterial partial pressure of carbon dioxide(PaCO_(2))],serum oxidative stress indexes[malondialdehyde(MDA),superoxide dismutase(SOD)]and pain mediators[serum prostaglandin E2(PGE_(2)),substance P(SP),neuropeptide Y(NPY)]perioperative operative indicators(intraoperative blood loss,operative time,chest tube drainage time,postoperative drainage volume,length of hospital stay),postoperative pain scores at different times and incidence of complications were compared between the two groups before and after operation.Results Before surgery,there were no statistically significant differences in blood gas indexes,serum oxidative stress indexes and pain mediators between the two groups(P>0.05).Compared with before operation,the levels of PaO_(2),MDA,PGE_(2),SP and NPY in 2 groups were higher after operation,while the levels of PaCO_(2) and SOD were lower,the differences were significant(P<0.05).After surgery,compared with the control group,the levels of PaO_(2) and SOD in the study group were(83.52±10.86)mmHg and(41.15±6.63)U/mL,which were higher than those in the control group[(76.19±12.27)mmHg,(36.91±5.37)U/mL],the levels of PaCO_(2),MDA were(40.48±8.41)mmHg,(7.69±2.11)nmol/L,which were lower than those in the control group[(45.97±9.73)mmHg,(9.76±3.08)nmol/L],the differences were statistically significant(P<0.05).The levels of PGE_(2),SP,NRY,intraoperative blood loss,postoperative drainage,and complication rates in th
作者
冯征
周勇安
张天意
程少毅
尹逊亮
FENG Zheng;ZHOU Yong-an;ZHANG Tian-yi(Tangdu Hospital,Air Force Military Medical University,Xi'an Shaanxi 710038,China)
出处
《临床和实验医学杂志》
2022年第4期378-381,共4页
Journal of Clinical and Experimental Medicine
基金
陕西省重点研发项目(S2017-ZDYF-ZDXM-SF-0226)。
关键词
自发性气胸
全肌肉分离
单孔胸腔镜
氧化应激反应
疼痛介质
Spontaneous pneumothorax
Total muscle separation
Single-port thoracoscopy
Oxidative stress response
Pain mediator
