自发性气胸采用胸腔镜治疗对控制术后肺部感染及远期复发的临床研究

发布时间：2018-09-19 07:04

【摘要】：目的观察自发性气胸采用胸腔镜治疗对控制术后肺部感染及远期复发的效果,以期为临床诊疗提供参考。方法分析2013年1月-2015年1月在医院接受手术治疗149例自发性气胸患者的临床资料;依据手术方法的不同分为观察组(胸腔镜手术,73例)及对照组(开胸手术,76例);分析两组患者术后肺部感染的发生率及病原菌分布,随访观察患者术后1年气胸复发率。结果观察组患者术后肺部感染发生率显著低于对照组患者(2.7%,2/73VS 11.8%,9/76;χ~2=4.512,P=0.034),观察组患者术后住院时间、术后下床时间及手术切口长度均显著小于对照组(P0.05),11例肺部感染灶共鉴定出革兰阴性菌7株占63.64%及革兰阳性菌4株占36.36%;术后2天,观察组患者外周血IL-6、IL-8低于对照组水平,PCT水平高于对照组,差异有统计学意义(P0.05),观察组患者术后1年气胸累积复发率显著低于对照组,差异有统计学意义(13.70%,10/73vs 32.89%,25/76;Log-rankχ~2=7.994,P=0.005)。结论与开胸手术相比,胸腔镜治疗自发性气胸可有效降低术后肺部感染发生率及远期术后复发。
[Abstract]:Objective to observe the effect of thoracoscopic treatment on the control of postoperative pulmonary infection and long-term recurrence of spontaneous pneumothorax, so as to provide reference for clinical diagnosis and treatment. Methods the clinical data of 149 patients with spontaneous pneumothorax were analyzed from January 2013 to January 2015. According to the different operation methods, the patients were divided into the observation group (73 cases) and the control group (76 cases), the incidence of pulmonary infection and the distribution of pathogenic bacteria were analyzed, and the recurrence rate of pneumothorax was observed after 1 year follow up. Results the incidence of postoperative pulmonary infection in the observation group was significantly lower than that in the control group. The time of getting out of bed and the length of incision after operation were significantly less than those in the control group (P0.05). 7 strains of Gram-negative bacteria (63.64%) and 4 strains of Gram-positive bacteria (36.36%) were identified in 11 cases of pulmonary infection, 2 days after operation. The level of IL-6,IL-8 in peripheral blood of the observation group was significantly lower than that of the control group (P0.05). The cumulative recurrence rate of pneumothorax in the observation group was significantly lower than that in the control group (13.70% vs 32.8925% 76Log-rank P 0.005). Conclusion compared with thoracotomy, thoracoscopic treatment of spontaneous pneumothorax can effectively reduce the incidence of postoperative pulmonary infection and long-term recurrence.
【作者单位】：丽水市人民医院胸心外科;
【分类号】：R563.1

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