摘要
目的 评价可视化精准膨肺用于胸腔镜肺段切除术中确定段间平面的效果.方法 择期全身麻醉下拟行胸腔镜肺段切除术患者64例,性别不限,年龄33～77岁,BMI 16～34 kg/m2,ASA分级Ⅰ或Ⅱ级,术前均采用三维CT支气管血管重建肺血管、支气管及虚拟的肺段间平面.采用随机数字表法分为2组(n=32):可视化精准膨肺组(V组)和改良膨胀萎陷组(E组).V组采用可视化精准膨肺确定段间平面,E组采用改良膨胀萎陷法确定段间平面.记录2组患者术中段间平面确定时间、靶段支气管辨认及处理时间、麻醉时间、手术时间、术后漏气、肺不张、发热、肺部感染发生情况、术后24 h引流量、引流管拔除时间和住院时间.结果 与E组比较,V组段间平面确定时间、靶段支气管辨认及处理时间、麻醉时间和手术时间缩短(P＜0.05);2组患者术后24 h引流量、引流管拔除时间、住院时间和术后肺部并发症发生率比较差异无统计学意义(P＞0.05).结论 与改良膨胀萎陷法相比,可视化精准膨肺可显著缩短胸腔镜肺段切除术中段间平面确定时间.
Abstract
Objective To evaluate the efficacy of visualized precise lung expansion for determining the intersegmental plane in thoracoscopic segmentectomy.Methods Sixty-four American Society of Anes-thesiologists Physical Status classification Ⅰ or Ⅱ patients,regardless of gender,aged 33-77 yr,with body mass index of 16-34 kg/m2,undergoing elective thoracoscopic segmentectomy under general anesthesia,were included.They were preoperatively reconstructed with 3D CT bronchovascularization to reconstruct the pulmonary vasculature,bronchus,and the virtual intersegmental planes of the lungs.The patients were di-vided into 2 groups(n=32 each)using a random number table method:visualized precise lung expansion group(group V)and modified expansion and atrophy group(group E).Group V used visualized precision lung expansion to determine the intersegmental planes,and group E used the modified expansion and atro-phy method to determine the intersegmental planes.The intraoperative intersegmental plane determination time,target segmental bronchus identification and treatment time,anesthesia time,operation time,postop-erative air leakage,pulmonary atelectasis,fever,occurrence of lung infection,postoperative 24 h drainage volume,drain removal time and hospitalization time were recorded in the two groups.Results Compared with group E,the intersegmental plane determination time,target segment bronchial identification and treat-ment time,anesthesia time and operation time were significantly shortened in group V(P＜0.05).There were no significant differences between groups in the 24 h postoperative drainage volume,drain removal time,hospitalization time or incidence of postoperative pulmonary complications(P＞0.05).Conclusions Compared with the modified expansion and atrophy method,visualized precise lung expansion can effectively shorten the intersegmental plane determination time in thoracoscopic segmentectomy.
基金项目
济南市科技局临床医学科技创新计划项目基金(202019017)
NETL
NSTL
万方数据