冷冻在电子支气管镜下肉芽组织清除术中的疗效观察

Observation on the therapeutic effect of cryotherapy in the removal of granulation tissue under electronic bronchoscope

摘要:

目的 探讨冷冻在电子支气管镜下肉芽组织清除术中的应用疗效，以期为肉芽组织清除术患者找到一种高效、安全的辅助技术。方法 选择2021年6月－2022年6月该院收治的41例行肉芽组织清除术的患者作为研究对象，采用单双号对患者进行分组，21例分到单号者为对照组，20例分到双号者为观察组。两组患者均行电子支气管镜下肉芽组织清除术治疗。术中，对照组给予氩等离子体凝固术（APC）治疗，观察组给予冷冻治疗，比较两组患者治疗前后的免疫功能指标水平（CD4⁺、CD8⁺和CD4⁺/CD8⁺等）、术后恢复相关指标和治疗总有效率等。结果 治疗前，两组患者CD4⁺和CD4⁺/CD8⁺比较，差异均无统计学意义（P > 0.05），治疗后，观察组CD4⁺和CD4⁺/CD8⁺明显高于对照组，差异均有统计学意义（P < 0.05）；治疗前，两组患者CD8⁺比较，差异无统计学意义（P > 0.05），治疗后，观察组CD8⁺明显低于对照组，差异有统计学意义（P < 0.05）；观察组有效率为95.00%，高于对照组的80.95%，观察组术后疼痛视觉模拟评分法（VAS）为（2.14±0.18）分，明显低于对照组的（6.09±0.95）分，差异均有统计学意义（P < 0.05）；观察组术后首次进食时间为（6.08±0.76）h，住院时间为（5.12±0.68）d，明显短于对照组的（15.39±2.97）h和（7.08±0.93）d，观察组治疗费用为（10 500.60±80.70）元，明显低于对照组的（19 800.00±126.00）元，差异均有统计学意义（P < 0.05）；观察组术后并发症发生率为5.00%，明显低于对照组的23.81%，差异有统计学意义（P < 0.05）。结论 冷冻在电子支气管镜下肉芽组织清除术中的应用较好，不仅能提高治疗效果，改善机体免疫指标水平，还能减轻术后疼痛，降低术后并发症发生率，缩短预后周期，且治疗费用低，值得临床推广应用。

Abstract:

Objective To explore and analyze the therapeutic effect of cryotherapy in the removal of granulation tissue under electronic bronchoscope, and find an efficient and safe auxiliary treatment technique for patients undergoing granulation tissue removal surgery.Method A clinical practice study was conducted on 41 patients who underwent granulation tissue removal surgery from June 2021 to June 2022. Patients were divided into groups using single and double numbers, with 21 patients assigned to single numbers included in the control group and 20 patients assigned to double numbers included in the observation group. Both groups underwent electronic bronchoscope granulation tissue removal surgery. During the surgery, the control group received argon-plasma coagulation (APC), while the observation group received cryotherapy. The levels of immune function indicators (including CD4⁺, CD8⁺ and CD4⁺/CD8⁺), postoperative recovery related indicators, and effective rate of the two groups of patients were compared before and after treatment.Result Before treatment, there was no statistically significant difference in CD4⁺ and CD4⁺/CD8⁺ between the two groups of patients (P > 0.05). After treatment, CD4⁺ and CD4⁺/CD8⁺ in the observation group were significantly higher than those in the control group, and the differences were statistically significant (P < 0.05); Before treatment, there was no statistically significant difference in CD8⁺ between the two groups of patients (P > 0.05). After treatment, the observation group was significantly lower than the control group, and the difference was statistically significant (P < 0.05); The effective rate of the observation group was 95.00%, higher than 80.95% of the control group. The postoperative pain visual analogue scale (VAS) of the observation group was (2.14 ± 0.18) points, significantly lower than the control group's (6.09 ± 0.95) points, and the differences were statistically significant (P < 0.05); The first postoperative feeding time of the observation group was (6.08 ± 0.76) hours, and the hospital stay was (5.12 ± 0.68) days, which were shorter than the control group's (15.39 ± 2.97) hours and (7.08 ± 0.93) days; The treatment cost of the observation group was (10 500.60 ± 80.70) yuan, which was lower than the control group's (19 800.00 ± 126.00) yuan, and the differences were statistically significant (P < 0.05); The incidence of postoperative complications in the observation group was 5.00%, lower than the control group's 23.81%, and the difference was statistically significant (P < 0.05).Conclusion The application of cryotherapy in the removal of granulation tissue under electronic bronchoscope has a significant therapeutic effect. It can not only improve the surgical treatment effect of patients, improve their immune index levels, but also alleviate their postoperative pain, reduce the incidence of postoperative complications, and shorten their postoperative pre - and post cycle. Moreover, the treatment cost is low, and it is worthy of clinical application and promotion.