张晓洁, 陈志明, 张秋实, 等 电视胸腔镜下肺减容术对重度慢性阻塞性 .docVIP

修稿意见：随机分组有违医学伦理，且临床实际工作中无法做到随机分组吧 冶治1972-），男回族青海省人民医院胸外科副主任医师电发票抬头青海省人民医院胸外科胸腔镜肺减容术治疗72例终末肺气肿患者的临床效果研究冶治鄂德锈郭亚楠高哲俊杨林江青海省人民医院胸外科青海810007?） 【摘要】目的探讨胸腔镜肺减容术终末肺气肿的临床。方法本文选择我院201年月-201年4月收治的例患者根据患者意愿分为组（n=）和对照组（n=。对照组采用，组治疗。观察比较两组结果±0.77 d vs 4.05±0.95 d），术中出血量较少（98.74±29.56 ml vs 205.41±33.28 ml），胸腔引流量较少（549.13±42.26 ml vs 792.28±50.17 ml），术后引流时间及住院时间较短（4.78±1.53 d vs 8.25±2.06 d，9.62±1.85 d vs 16.23±3.04 d）（P0.05）。术后第1、3、5、7天VAS评分均明显低于对照组（P）P0.001），RV及PaCO2明显下降（P0.001），但两组患者术后组间比较未见统计学差异（P0.05）。TNF-a、IL-1及IL-6均明显升高（P0.001），观察组升高幅度明显低于对照组（239.62±24.85 ng/L vs 403.22±33.59 ng/L；23.19±2.36 ng/L vs 38.53±3.85 ng/L；135.21±13.82 ng/L vs 186.69±16.30 ng/L）（P0.001）。结论治疗【关键词】；胸腔镜肺减容术；；Clinical effect study?of thoracoscopic lung volume reduction surgery in the treatment of terminal emphysema [Abstract] Objective This study aims to investigate the clinical effect of thoracoscopic lung volume reduction surgery in the treatment of terminal emphysema. Methods According to patients wishes, 72 patients admitted to our hospital from May 2012 to April 2016 were divided into observation group (n=36) and control group (n=36). The control group was treated with traditional lung volume reduction surgery, and the observation group was treated by thoracoscopic lung volume reduction surgery. It observed and compared with the basic operation index including the amount of blood loss, VAS score, pulmonary function, blood gas analysis and serum levels of inflammatory factors. Results Compared with control group, the postoperative leakage time of observation group was shorter (3.42±0.77 d vs 4.05±0.95 d), the amount of bleeding and thoracic drainage were less (98.74±29.56 ml vs 205.41±33.28 ml, 549.13±42.26 ml vs 792.28±50.17 ml), the time of postoperative drainage and hospital stay were shorter (4.78±1.53 d vs 8.25±2.06 d, 9.62±1.85 d vs 16.23±3.04 d) (P0.05). After operation, the VAS score at 1, 3, 5, 7 days in the operation group were significantly lower than those of in the con