电视胸腔镜下肺减容术对重度慢性阻塞性肺气肿患者炎性因子、肺功能及生活质量的影响

Impact of lung volume reduction surgery on inflammatory factors, pulmonary function and quality of life in patients with severe chronic obstructive pulmonary emphysema

摘要:

目的 探讨电视胸腔镜下肺减容术对重度慢性阻塞性肺气肿患者炎性因子、肺功能及生活质量的影响。方法 选择2009年5月-2013年12月在该院接受肺减容术治疗的慢性阻塞性肺气肿患者57例为研究对象，根据入院时间先后顺序随机分为观察组32例和对照组25例，对照组接受开胸肺减容手术，观察组接受电视胸腔镜下肺减容手术，比较两组患者手术指标、血清炎性因子含量、肺功能和生活质量。结果 手术指标：观察组术中出血量、胸引流量和住院时间等均明显低于对照组（P <0.05）；炎性因子：手术3天后，观察组血清肿瘤坏死因子-α（TNF-α）、白细胞介素-1（IL-1）、白细胞介素-6（IL-6）含量明显低于对照组（P <0.05）；肺功能：手术12个月后，两组患者的第1秒用力呼气容积（FEV1）、肺总量（TLC）和残气量（RV）比较，差异无统计学意义（P > 0.05）；圣乔治呼吸问卷（SGRQ）评分：手术后12周，观察组呼吸症状、活动能力、疾病影响和总分等评分均明显低于对照组（P <0.05）。结论 电视胸腔镜下肺减容术有助于减轻手术创伤程度，缓解炎性反应，提高生活质量。

Abstract:

Objective To study the impact of lung volume reduction surgery on inflammatory factors, pulmonary function and quality of life in patients with severe chronic obstructive pulmonary emphysema. Methods 57 cases patients with severe chronic obstructive pulmonary emphysema received lung volume reduction surgery from May 2009 to December 2013 were divided into observation group 32 cases and control group 25 cases, the control group were given open chest surgery, the observation group received video-assisted thoracoscopic surgery. Then compare the operation indicator, serum inflammatory factor content, pulmonary function and life quality score between the two groups. Results Operation indicators: Observation group: Intraoperative blood loss, thoracic drainage, hospital stay were significantly lower than that in control group (P < 0.05); Inflammatory factor: 3 d after surgery, observation group serum TNF-α, IL - 6, IL - 1 content were significantly lower than that in control group (P < 0.05); Pulmonary function: 12 months after surgery, there were no statistical difference of FEV1, TLC, RV between two groups (P > 0.05); SGRQ score: 12 weeks after the surgery, observation group respiratory symptoms, activity ability, disease impact, SGRQ total score were significantly lower than the control group (P < 0.05). Conclusion Video assisted thoracic surgery helps to reduce surgical trauma, and alleviate inflammatory reaction, then improve the quality of life.