实用心脑肺血管病杂志
實用心腦肺血管病雜誌
실용심뇌폐혈관병잡지
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
2015年
7期
75-77
,共3页
气胸%肺大疱微创切除术%胸膜固定术%滑石粉
氣胸%肺大皰微創切除術%胸膜固定術%滑石粉
기흉%폐대포미창절제술%흉막고정술%활석분
Pneumothorax%Pulmonary bulla minimally invasive resection%Pleurodesis%Pulvis talci
目的：探究胸膜摩擦与滑石粉单用或联用固定对肺大疱微创切除术患者的影响。方法选取长沙市中心医院胸外科2013年8月—2014年8月收治的行肺大疱微创切除术患者180例，按治疗方法不同分为A组、 B组及C组，每组60例。 A组患者术中行胸膜摩擦固定， B组患者术中行滑石粉固定， C组患者术中行胸膜摩擦＋滑石粉固定。比较3组患者围术期临床指标（手术时间、术后插管时间、住院时间及镇痛药物使用情况）和术后并发症发生情况。结果3组患者术后插管时间比较，差异无统计学意义（ P＞0.05）； B组患者手术时间短于A组和C组（ P＜0.05）；A组患者住院时间长于B组和C组（ P＜0.05）； C组患者镇痛药物使用频率高于A组和B组（ P＜0.05）。3组患者肺炎及肺不张发生率比较，差异无统计学意义（P＞0.05）； C组患者高热发生率高于A组和B组（P＜0.05）； A组患者胸腔积液和胸部残腔发生率均高于B组和C组（P＜0.05）。结论肺大疱微创切除术患者术中行滑石粉单用固定可有效缩短手术时间，加快术后康复进程，且不增加术后并发症发生率，应用价值优于胸膜摩擦单用和胸膜摩擦与滑石粉联用。
目的：探究胸膜摩抆與滑石粉單用或聯用固定對肺大皰微創切除術患者的影響。方法選取長沙市中心醫院胸外科2013年8月—2014年8月收治的行肺大皰微創切除術患者180例，按治療方法不同分為A組、 B組及C組，每組60例。 A組患者術中行胸膜摩抆固定， B組患者術中行滑石粉固定， C組患者術中行胸膜摩抆＋滑石粉固定。比較3組患者圍術期臨床指標（手術時間、術後插管時間、住院時間及鎮痛藥物使用情況）和術後併髮癥髮生情況。結果3組患者術後插管時間比較，差異無統計學意義（ P＞0.05）； B組患者手術時間短于A組和C組（ P＜0.05）；A組患者住院時間長于B組和C組（ P＜0.05）； C組患者鎮痛藥物使用頻率高于A組和B組（ P＜0.05）。3組患者肺炎及肺不張髮生率比較，差異無統計學意義（P＞0.05）； C組患者高熱髮生率高于A組和B組（P＜0.05）； A組患者胸腔積液和胸部殘腔髮生率均高于B組和C組（P＜0.05）。結論肺大皰微創切除術患者術中行滑石粉單用固定可有效縮短手術時間，加快術後康複進程，且不增加術後併髮癥髮生率，應用價值優于胸膜摩抆單用和胸膜摩抆與滑石粉聯用。
목적：탐구흉막마찰여활석분단용혹련용고정대폐대포미창절제술환자적영향。방법선취장사시중심의원흉외과2013년8월—2014년8월수치적행폐대포미창절제술환자180례，안치료방법불동분위A조、 B조급C조，매조60례。 A조환자술중행흉막마찰고정， B조환자술중행활석분고정， C조환자술중행흉막마찰＋활석분고정。비교3조환자위술기림상지표（수술시간、술후삽관시간、주원시간급진통약물사용정황）화술후병발증발생정황。결과3조환자술후삽관시간비교，차이무통계학의의（ P＞0.05）； B조환자수술시간단우A조화C조（ P＜0.05）；A조환자주원시간장우B조화C조（ P＜0.05）； C조환자진통약물사용빈솔고우A조화B조（ P＜0.05）。3조환자폐염급폐불장발생솔비교，차이무통계학의의（P＞0.05）； C조환자고열발생솔고우A조화B조（P＜0.05）； A조환자흉강적액화흉부잔강발생솔균고우B조화C조（P＜0.05）。결론폐대포미창절제술환자술중행활석분단용고정가유효축단수술시간，가쾌술후강복진정，차불증가술후병발증발생솔，응용개치우우흉막마찰단용화흉막마찰여활석분련용。
Objective To investigate the impact of single or joint use of pleural friction or talcum powder on postoperative patients undergoing pulmonary bulla minimally invasive resection.Methods From August 2013 to August 2014, a total of 180 postoperative patients undergoing pulmonary bulla minimally invasive resection were selected in the Department of Chest Surgery, Changsha Centeral Hospital, and they were divided into groups A, B and C according to therapeutic methods, each of 60 cases.Patients of A group were given pleural friction only during surgery, patients of B group were given talcum powder only during surgery, while patients of C group were given pleural friction combined with talcum powder during surgery.Surgery duration, tracheal intubation time after surgery, hospital stays and usage of analgesic drugs and incidence of postoperative complications were compared among the three groups.Results No statistically significant differences of tracheal intubation time after surgery was found among the three groups ( P>0.05 ); surgery duration of B group was statistically significantly shorter than that of A group, C group, respectively ( P<0.05); hospital stays of A group was statistically significantly longer than that of B group, C group, respectively (P<0.05); the usage rate of analgesic drugs of C group was statistically significantly higher than that of A group, B group, respectively (P<0.05).No statistically significant differences of incidence of pneumonia or pulmonary atelectasis was found among the three groups ( P>0.05); the incidence of hyperpyrexia of C group was statistically significantly higher than that of A group, B group, respectively ( P<0.05); the incidence of pleural effusion and chest residual cavity of A group were statistically significantly higher than those of B group, C group, respectively (P<0.05).Conclusion Single use of talcum powder during surgery can effectively shorten the surgery duration, quicken the postoperative rehabilitation process of patients undergoing pulmonary bulla minimally invasive resection, without increasing the incidence of postoperative complications, has better clinical effect than single use of pleural friction or joint use of pleural friction and talcum powder.
