聚氨基葡萄糖羧酸钠在肺叶切除术中的应用价值
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湖南省科技厅资助项目(05FJ30009)


Application value of sodium polyglucosamine carboxylate in pulmonary lobectomy
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    摘要:

    目的 探讨聚氨基葡萄糖羧酸钠在肺叶切除术中的应用价值。方法 选取2016年2月~2018年3月我院就诊的115例肺叶切除术患者为研究对象,按照随机数表法分为观察组(n=60)和对照组(n=55)。对照组给予常规的生理盐水冲洗胸腔,观察组在胸腔关闭前用医用聚氨基葡萄糖羧酸钠冲洗胸腔,术后两组患者持续镇痛48 h。比较两组患者围术期情况、视觉模拟疼痛评分(VAS)、血清炎症因子、术后恢复情况的变化及术后并发症。结果 观察组术后3天的胸管引流量、失血量少于对照组,拔管时间、住院时间短于对照组,且发热超过48 h和手术切口的愈合情况优于对照组(均P<0.05);术后观察组在T1(2h)、T2(12 h)、T3(24 h)、T4(48 h)的VAS评分低于对照组(均P<0.05);观察组术后1天的血清炎症因子白细胞计数(WBC)、C-反应蛋白(CRP)、降钙素原(PCT)指标水平明显低于对照组(均P<0.05);观察组患者术后肛门恢复排气时间和胃肠减压量少于对照组(均P<0.05);两组在治疗期间均未出现肺不张、呼吸衰竭、肺炎、残余肺坏死等明显术后并发症。结论 聚氨基葡萄糖羧酸钠在肺叶切除术中具有杀菌消炎、减少失血量的作用,能改善患者术后的愈合情况,缩短住院时间,可在在临床应用推广。

    Abstract:

    Objective To study application value of sodium polyglucosamine carboxylate in pulmonary lobectomy.Methods 115 patients with lobectomy admitted to our hospital from February 2016 to March 2018 were randomly divided into observation group (n=60) and control group (n=55). The control group was given normal saline to wash the thoracic cavity. The group was washed with medical sodium glucosamine carboxylate before the chest was closed, and the two groups of patients continued to have analgesia for 48 hours. The perioperative conditions, visual analog pain score (VAS), serum inflammatory factors, postoperative recovery, and postoperative complications were compared between the two groups. Results The drainage volume and blood loss of thoracic tube in the observation group were less than those in the control group 3 days after operation, and the extubation time and hospitalization time in the observation group were shorter than those in the control group. The fever lasted for more than 48 hours and the healing of surgical incision in the observation group were better than those in the control group(P<0.05). The VAS scores of T1 (2h), T2 (12h), T3 (24h) and T4 (48h) were lower in the postoperative observation group than in the control group(P<0.05). The level of serum inflammatory factor white blood cell count (WBC), C-reactive protein (CRP), and procalcitonin (PCT) levels in the observation group was significantly lower than that of the control group(P<0.05). The recovery time of anal exhaust and the amount of gastrointestinal decompression in the observation group were less than those in the control group(P<0.05). There were no obvious complications such as atelectasis, respiratory failure, pneumonia and residual lung necrosis during treatment in both groups. Conclusion The sodium polyglucosamine carboxylate has bactericidal and antiinflammatory effects in pulmonary lobectomy, reducing blood loss, improving the healing of patients after operation and shortening hospital stay, which is worthy of promotion in clinical application.

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  • 在线发布日期: 2020-08-17
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