Clinical Study Of Single-hole Thoracoscopic Bullous Resection With Non-tracheal Intubation

Objective To explore whether single-hole thoracoscopic bullous resection with self-respiratory and non-tracheal intubation is safe,practical and efficient.At the same time,to compared the difference between it and traditional thoracoscopic bullous resection on subjective feeling,inflammation,blood gas exchange capacity,rehabilitation and the incidence rates of complications after operations.Provide a theoretical basis for clinical work.Methods According to the set inclusion and exclusion criteria,63 patients who were diagnosed as spontaneous pneumothorax and underwent thoracoscopic bullous resection in the Department of Thoracic Surgery,No.940 Hospital of Joint Logistics Support Force from December 2017 to January 2019 as the subjects of the study were divided into the experimental group of 30 cases and the control group of 33 cases according to the random number table method.The clinical baseline materials were collected,and the heart rate(HR),mean arterial pressure(MAP),and arterial oxygen partial pressure(PaO2)of the two groups of patients during the two stages of cutting the suture resection(t1)and the end of the operation(t2)were collected.And the data of arterial blood carbon dioxide partial pressure(PaCO2)in patients with t1,bispectral index(BIS)at t1,operating room time,the volume of intraoperative blood loss,and whether the experimental group had intraoperative stimuli cough were collected.The pain scores of the first and third days after surgery,the patient comfort score on the first day after surgery,the white blood cell count(WBC)on the first day after surgery,and the C-reactive protein(CRP)on the first day after surgery,procalcitonin(PCT)and interleukin-6(IL-6)on the second day after surgery,the time of antibiotic use after surgery,the arterial partial pressure of oxygen(PaO2)and oxygen Index(PaO2/FiO2)on the first day after surgery,postoperative bed rest time,drainage tube indwelling time,postoperative feeding time,postoperative hospital stay,hospitalization expenses,and postoperative complications' rates were collected.These data were analyzed by statistical software SPSS25.0.Results Only one patient of the experimental group was treated with irritating cough during the operation and after symptomatic treatment,the condition was relieved and the operation was successfully completed.The remaining patients of two groups successfully completed the operation.Comparison of the two groups of patients in the operating room time,heart rate(t1,t2),arterial carbon dioxide tension(T1),bispectral index(T1),pain score(D1,D2),the comfort score,white blood cell count,C response protein,interleukin-6,postoperative antibiotics,PaO2,PaO2/FiO2,postoperative hospital stay,postoperative bed time,hospitalization cost,and the rats of postoperative complication rates has statistical differences(P<0.05).And there was no statistically significant difference in the amount of intraoperative blood loss,MAP(t1,t2),PaO2,procalcitonin,and postoperative drainage tube(P>0.05).Conclusion 1.Single-hole thoracoscopic bullous resection with self-breathing and non-tracheal intubation is practical and safe,and the efficiency of this procedure requires further study.2.Single-hole thoracoscopic bullous resection with self-breathing and non-tracheal intubation is better than traditional thoracoscopic bullous resection,and the blood gas exchange capacity is better and the inflammation level is lower.3.Single-hole thoracoscopic bullous resection with spontaneous breathing and non-tracheal intubation compared with conventional thoracoscopic bullous resection,patients had faster postoperative recovery,better postoperative subjective experience,lower complications' rates and less surgery costs.