全胸腔镜下肺叶切除术治疗支气管扩张及对患者动脉血气影响的研究

目的探讨全胸腔镜下肺叶切除术治疗支气管扩张的效果及其对患者动脉血气的影响.方法选取146例肺叶切除术治疗支气管扩张患者,按照手术方式不同分为观察组和对照组,对照组73例患者采用传统开胸手术,观察组73例患者进行全胸腔镜手术,比较两组患者的手术效果及术后动脉血气情况.结果观察组总有效率为94.52%,相比对照组(89.04%)差异具有统计学意义(P0.05);观察组患者手术时间和术后住院时间均短于对照组患者,术中出血量和术后胸腔引流量较对照组有较大幅度减少,差异具有统计学意义(P0.05);术后第1天和第3天,两组患者的PaO_2水平存在显著统计学意义(P0.05),其余时间点两组间比较差异无统计学意义(P0.05);手术前及术后不同时间点观察组和对照组患者的PaCO_2和pH水平变化不明显,不同时间点两组差异无统计学意义(P0.05).结论全腔镜下肺叶切除术治疗支气管扩张较传统开胸手术损伤轻微、出血量少、术后恢复快,有较好的治疗效果,对患者的动脉血气影响也相对较小,并发症发生率较低,具有临床研究与应用价值.

Total Thoracoscopic Pulmonary Lobectomy on the Treatment of Bronchiectasis and Its Influence on Arterial Blood Gas in Patients

Objective To explore the effect of the total thoracoscopic pulmonary lobectomy on the treatment of bronchiectasis and its influence on arterial blood gas in patients. Method A total of 146 patients with bronchiectasis who were treated by pulmonary lobectomy were enrolled in this research, and they were divided into two groups according to the surgery method. The control group ( n=73 ) was treated with traditional open chest operation,while the observation group (n=73) was treated with total thoracoscopic lobectomy. The curative effects of the operations and arterial blood gas situations were compared between the two grups after operation. Results The total effective rate of the observation group was significantly higher than that of the control group (P<0. 05). Compared with the control group,the operation time and postoperative hospitalization time of the observation group were both shorter (P<0. 05),the amount of intraoperation bleeding and postoperative drainage volume of the observation group were obviously less (P<0. 05). At the 1st and the 3rd day postoperatively,the levels of PaO2 were statistically significant difference between the two groups (P<0. 05),but the differences were no significant at other time points (P>0. 05). The changes of PaCO2 and pH in both the two groups were not obvious before and after surgery, and the differences on the levels of PaCO2 and pH between the two groups showed no statistical differences at different time points ( P>0 . 05 ) . Conclusion Compared with traditional open chest operation,the total thoracoscopic lobectomy cause slighter damage,less intraoperation bleeding and faster postoperative recovery,and its influence on arterial blood gas is relatively small. Therefore,it is worthy of clinic research and application.