目的 分析单孔电视辅助胸腔镜手术(VATS)对患者围手术期指标、肺功能的影响。方法 将2021-01至2022-10海警医院收治的肺结节患者80例按手术方式分为对照组、观察组,每组40例。对照组予常规多孔VATS治疗,观察组予单孔VATS治疗,比较两组围手术期指标、肺功能、免疫功能与氧化应激指标。结果 治疗后,单孔VATS组的手术时长、术中失血量、术后引流液总量、术后疼痛评分、术后胸腔闭式引流持续时长及住院总费用均优于多孔VATS组(P＜0.05),但两组住院总时长差异无统计学意义。单孔VATS组治疗后与治疗前比较,分钟最大通气量(MVV)、用力肺活量(FVC)和第1秒用力呼气容积(FEV1)下降;治疗后两组的MVV、FVC差异无统计学意义,但单孔VATS组FEV1(1.65±0.39)L高于对照组的(1.39±0.57)L,差异有统计学意义(P＜0.05)。单孔VATS组治疗后与治疗前比较,血清还原型烟酰胺腺嘌呤二核苷酸磷酸氧化酶2(NOX2)相对表达量、NOX4相对表达量升高,免疫球蛋白M(IgM)和IgA下降;治疗后单孔VATS组NOX2相对表达量、NOX4相对表达量低于多孔VATS组,IgM和IgA单孔VATS组高于多孔VATS组,差异有统计学意义(P＜0.05)。结论 与常规多孔VATS治疗相比,肺结节患者接受单孔VATS治疗获得了更佳的围手术期指标,患者的肺功能和免疫功能与氧化应激指标均得到了明显改善,具有较高的临床应用价值。
Abstract
Objective To analyze the effects of single-port video-assisted thoracoscopic surgery (VATS) on perioperative indicators and pulmonary function in patients with pulmonary nodules. Methods A total of 80 patients with pulmonary nodules admitted to the Coast Guard Hospital from January 2021 to October 2022 were divided into a control group and an observation group based on the surgical method, with 40 cases in each group. The control group was treated with conventional multi-port VATS, while the observation group underwent single-port VATS. The perioperative indicators, pulmonary function, immune function and oxidative stress markers were compared between the two groups. Results After treatment, the operative duration, intraoperative blood loss, total volume of postoperative drainage fluid, postoperative pain score, duration of postoperative closed thoracic drainage, and total hospitalization cost in the observation group were superior to those in the control group (P<0.05), but no statistically significant difference was observed in the hospital stay between the two groups. Compared with preoperative values, postoperative measurements in the observation group showed a decrease in maximum voluntary ventilation (MVV), forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1). No significant differences in MVV or FVC were observed between the two groups after treatment, but the FEV1 in the observation group(1.65±0.39)L was higher than that in the control group (1.39±0.57)L, with statistically significant differences (P<0.05). Compared with pre-treatment levels, the relative expression levels of nicotinamide adenine dinucleotide phosphate oxidase 2 (NOX2) and nicotinamide adenine dinucleotide phosphate oxidase 4 (NOX4) increased, while immunoglobulin M (IgM) and immunoglobulin A (IgA) decreased in both groups after treatment. The relative expression levels of NOX2 and NOX4 in the observation group after treatment were lower than those in the control group, while the levels of IgM and IgA in the observation group were higher than those in the control group, with statistically significant differences (P<0.05). Conclusions Compared with conventional multi-port VATS, single-port VATS resulted in better perioperative indicators, as well as significant improvements in pulmonary function, immune function, and oxidative stress indicators in patients with pulmonary nodules, demonstrating high clinical application value.
关键词
肺结节 /
单孔胸腔镜手术 /
肺功能 /
围手术期指标 /
免疫功能与氧化应激指标
Key words
pulmonary nodules /
single-port thoracoscopic surgery /
pulmonary function /
perioperative indicators /
immune function and oxidative stress indicators
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