摘要
目的比较胸腔镜手术与开胸手术治疗创伤性血气胸的效果,以期为临床手术方式的选择提供参考。方法选取2017年1月至2020年8月本院诊治的100例创伤性血气胸患者作为研究对象,根据治疗方法将其分为胸腔镜组和开胸组,各50例。胸腔镜组行胸腔镜手术治疗,开胸组行开胸手术治疗。比较两组的手术指标及术后康复指标、术后并发症发生情况、血清炎症因子水平、应激反应指标。结果胸腔镜组的手术时间、胸管引流时间、住院时间短于开胸组,术中出血量、术后胸腔引流量少于开胸组,术后24 h的VAS评分低于开胸组,差异具有统计学意义(P<0.05)。胸腔镜组的术后并发症总发生率为6.0%,低于开胸组的20.0%,差异具有统计学意义(P<0.05)。术前1 d,两组的CRP、TNF-α、IL-1β水平比较,差异无统计学意义(P>0.05);术后1、3 d,胸腔镜组的CRP、TNF-α、IL-1β水平低于开胸组,差异具有统计学意义(P<0.05)。术前,两组的COR、PGE_(2)、ACTH、NE水平比较,差异无统计学意义(P>0.05);术后24 h,两组的COR、PGE_(2)、ACTH、NE水平均较术前升高,但胸腔镜组低于开胸组,差异具有统计学意义(P<0.05)。结论胸腔镜手术治疗创伤性血气胸的效果优于开胸手术,可降低术后并发症发生率,减轻全身炎症反应及应激反应的激活程度,促进术后康复,值得临床推广和应用。
Objective To compare the effect of thoracoscopic surgery and open thoracotomy in the treatment of traumatic hemopneumothorax,so as to provide reference for the selection of clinical operation methods.Methods A total of 100 patients with traumatic hemopneumothorax treated in our hospital from January 2017 to August 2020 were selected as the research objects.According to the treatment method,the patients were divided into thoracoscopic group and open thoracotomy group,with 50 cases in each group.The thoracoscopic group was treated with thoracoscopic surgery,and the open thoracotomy group was treated with open thoracotomy.The operation indexes,postoperative rehabilitation indexes,occurrence of postoperative complications,serum inflammatory factors levels and stress response indexes were compared between the two groups.Results The operation time,chest tube drainage time and hospital stay in the thoracoscopic group were shorter than those in the open thoracotomy group,the amount of intraoperative bleeding and postoperative thoracic drainage were less than those in the open thoracotomy group,the VAS score at 24 h after operation was lower than that in the open thoracotomy group,and the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the thoracoscopic group was 6.0%,which was lower than 20.0%in the open thoracotomy group,and the difference was statistically significant(P<0.05).At one day before operation,there were no significant differences in the CRP,TNF-αand IL-1βlevels between the two groups(P>0.05);at 1 and 3 d after operation,the CRP,TNF-αand IL-1βlevels in the thoracoscopic group were lower than those in the open thoracotomy group,and the differences were statistically significant(P<0.05).Before operation,there were no significant differences in the COR,PGE_(2),ACTH and NE levels between the two groups(P>0.05);at 24 h after operation,the COR,PGE_(2),ACTH and NE levels in the two groups were higher than those before operation,but those in the thoracoscop
作者
石维超
高琳英
SHI Weichao;GAO Linying(the Second Affiliated Hospital of Xi'an Medical University,Xi'an 710038,China)
出处
《临床医学研究与实践》
2022年第9期74-77,共4页
Clinical Research and Practice
关键词
创伤性血气胸
胸腔镜手术
开胸手术
traumatic hemopneumothorax
thoracoscopic surgery
open thoracotomy