胸腔镜碘酊胸膜固定术治疗恶性胸腔积液的临床研究
Clinical research on video-assisted thoracoscopic iodine tincture pleurodesis for treating malignant pleural effusion
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摘要: 目的：研究电视胸腔镜（video-assisted thoracoscopic surgery ，VATS）碘酊胸膜固定术治疗恶性胸腔积液的临床疗效。方法：回顾性分析47例恶性胸腔积液（malignant pleural effusion，MPE）患者的临床资料，按照疗法不同，分为碘酊硬化剂组25例，滑石粉硬化剂组22例，两组患者均为MPE 确诊病例，均行胸腔镜辅助胸膜活检加胸膜固定术，具有可比性。比较两组患者术后有效率（CR+PR）、平均总引流量、不良反应发生率、胸管留置时间。结果：所有患者术后呼吸困难症状均减轻，无急性肺损伤发生。碘酊组术后有效率96.0% ，滑石粉组有效率为95.5% ，组间比较差异无统计学意义（P>0.05）。 术后碘酊组不良反应率32.0% ；滑石粉组不良反应率63.6% 。两组术后不良反应有显著性差异（P<0.05）。 结论：VATS碘酊胸膜固定术同滑石粉胸膜固定对治疗MPE 有同样疗效，且较滑石粉不良反应少，治疗MPE 疗效确切、操作简单、使用安全、不良反应少、价格便宜，值得临床推广应用。Abstract: Objective: To observe the therapeutic effect of video-assisted thoracoscopic surgery (VATS) with iodine tincture pleurodesis on malignant pleural effusion (MPE).Methods:Clinical data from 47MPE cases were retrospectively analyzed. Based on different treatments, the 47cases were divided into Groups A (n. 25) and B (n. 22), which used iodine tincture and talc powder as a hard -ener, respectively. Provided that all cases were conclusively diagnosed as MPE, and the patients underwent VATS pleural biopsy and pleurodesis, Groups A and B were comparable. The authors then compared the postoperative effectiveness rates (both complete and par-tial remissions), the volume of chest drainage, the incidence of adverse reactions, and the drainage time of the chest tube between the two groups. Results: Difficulty in breathing was proven to be less severe among all cases after the operation, and none of the patients suffered from acute lung injuries. After the operation, Group A exhibited an effectiveness rate of 96.0%, whereas Group B presented a rate of 95.5%, which indicates that no significant difference was found between the two groups (P>0.05). The total incidence of adverse reactions was 32.0% in Group A and63.6% in Group B, with a significant difference between the two (P<0.05). Conclusion:VATS io-dine tincture pleurodesis has been proven to be as therapeutically effectual as talc pleurodesis and has resulted in fewer adverse reac-tions. This finding suggests that VATS iodine tincture pleurodesis has a promising potential in clinical practice because of its definite curative effect, simple management, high security, fewer adverse reactions, and reasonable cost.
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期刊类型引用(15)
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