Application value of artificial hydrothorax in preoperative preparation of medical thoracoscopy

doi:10.19983/j.issn.2096-8493.20220004

Abstract

Abstract: Objective: To explore the clinical value and safety of artificial hydrothorax in preoperative preparation of medical thoracoscopy.Methods: The clinical datas of 163 patients who hospiyalized in the Endoscopy Center of Hu’nan Chest Hospital and underwent medical thoracoscopic surgery because of pleural effusion or pleural disease from May 2014 to November 2019 were retrospectively analyzed. From January 2017 to November 2019, 115 pleural effusion patients who underwent artificial hydrothorax before the medical thoracoscopy were selected as the observation group. From May 2014 to December 2016, 48 pleural effusion patients who did not undergo artificial pleural thoracic examination before medical thoracoscopy were selected as the control group. The success rate and the complications in the observation group were analyzed, and the effective rate and lung injury of medical thoracoscopy were compared between the two groups.Results: The success rate of artificial hydrothorax in the observation group was 100.0% (115/115). A total of 27 cases (23.5%) had mild to moderate cough, dyspnea, subcutaneous mass in the chest wall, and local pain in the chest cavity during the water injection process. After oxygen inhalation, supine rest, adjust the body position and respiratory rate, stopping the operation, and other disposal, all patients were relieved, and there were no serious complications such as subcutaneous emphysema, hemothorax, infection, needle tract transfer, and air embolism related to the operation of artificial hydrothorax. In the observation group, the direct pathological diagnosis rate of medical thoracoscopy was significantly higher than that in the control group (92.2% (106/115) vs. 72.9% (35/48), χ ²=10.757, P=0.001), the operational efficiency was significantly higher than that in the control group (97.4% (112/115) vs. 85.4%(41/48), χ ²=6.481, P=0.011), and the lung injury rate was significantly lower than that of the control group (4.3% (5/115) vs. 18.8% (9/48), χ ²=7.206, P=0.007).Conclusion: The implementation of artificial hydrothorax before medical thoracoscopy can safely and effectively detect the thoracic cavity, improve the operation efficiency, expand the operation space, reduce lung injury during the operation.

Key words: Pleural effusion, Thoracoscopy, Evaluation studies, Hydropneumothorax, artificial

CLC Number:

R521
R560.4

LU Zhi-bin, LUO Li, LUO Lin-zi, XIAO Yang-bao. Application value of artificial hydrothorax in preoperative preparation of medical thoracoscopy[J]. Journal of Tuberculosis and Lung Disease , 2022, 3(2): 131-136. doi: 10.19983/j.issn.2096-8493.20220004

Figures/Tables 9

术前指征	合计	观察组(115例)	对照组(48例)	统计检验值	P值
性别[例(构成比,%)]				χ²=1.411	0.235
男性	126(77.3)	86(74.8)	40(83.3)
女性	37(22.7)	29(25.2)	8(16.7)
年龄(岁, $x ¯$ ±s)	49.0±16.4	47.6±16.8	52.3±15.0	t=0.685	0.409
超声测量胸膜厚度[例(构成比,%)]				χ²=3.199	0.074
增厚	61(37.4)	38(33.0)	23(47.9)
未增厚	102(62.6)	77(67.0)	25(52.1)
CT测量胸膜厚度[例(构成比,%)]				χ²=1.467	0.226
增厚	127(77.9)	87(75.7)	40(83.3)
无增厚	36(22.1)	28(24.3)	8(16.7)
超声评估胸腔粘连[例(构成比,%)]				χ²=1.111	0.292
有	95(58.3)	64(55.7)	31(64.6)
无	68(41.7)	51(44.3)	17(35.4)
CT评估胸腔粘连[例(构成比,%)]				χ²=0.574	0.449
有	119(73.0)	82(71.3)	37(77.1)
无	44(27.0)	33(28.7)	11(22.9)

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