电视辅助胸腔镜手术后肺泡漏气的预防：使用纤维蛋白胶方法的疗效比较
Prevention of alveolar air leakage after video-assisted thoracic surgery: comparison of the efficacy of methods involving the use of fibrin glue.
作者信息
Kawai Hideki, Harada Kenji, Ohta Hideki, Tokushima Takeshi, Oka Shiro
机构信息
Department of Thoracic Surgery, Akita Red Cross Hospital, 222-1 Naeshirosawa Saruta Kamikitate, Akita, Japan.
出版信息
Thorac Cardiovasc Surg. 2012 Jul;60(5):351-5. doi: 10.1055/s-0031-1293599. Epub 2011 Dec 29.
BACKGROUND
The aim of this study was to evaluate the appropriate condition of use of the fibrin glue plus polyglycolic acid (PGA) sheet combination to obtain the optimal sealing effect.
METHODS
126 consecutive patients underwent video-assisted thoracic surgery (VATS) were divided into groups as follows: fibrin glue sprayed on the PGA sheet placed over the pleural defect (Method I); fibrinogen and thrombin solutions sprayed separately on the PGA sheet soaked in thrombin and placed over the pleural defect after rubbing of fibrinogen solution on the area (Method II); fibrin glue sprayed on the PGA sheet placed over the pleural defect after rubbing of fibrinogen solution on the area (Method III). Method II and Method III were also examined in an animal model.
RESULTS
Postoperative air leakage was more effectively prevented by Method III than by the other two methods (p < 0.05). In the experimental study, a significantly higher seal-breaking pressure was obtained for Method III than for Method II (p < 0.05).
CONCLUSION
Method III was the most effective for preventing alveolar air leakage.
背景
本研究旨在评估使用纤维蛋白胶加聚乙醇酸（PGA）片组合以获得最佳密封效果的合适条件。
方法
126例连续接受电视辅助胸腔镜手术（VATS）的患者被分为以下几组：将纤维蛋白胶喷在置于胸膜缺损处的PGA片上（方法I）；将纤维蛋白原溶液和凝血酶溶液分别喷在浸泡过凝血酶的PGA片上，并在该区域涂抹纤维蛋白原溶液后将其置于胸膜缺损处（方法II）；在该区域涂抹纤维蛋白原溶液后，将纤维蛋白胶喷在置于胸膜缺损处的PGA片上（方法III）。方法II和方法III也在动物模型中进行了研究。
结果
方法III比其他两种方法更有效地预防了术后漏气（p < 0.05）。在实验研究中，方法III获得的密封破坏压力明显高于方法II（p < 0.05）。
结论
方法III在预防肺泡漏气方面最有效。
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