中国内镜杂志2026，Vol.32Issue(3)：1-8,8.DOI:10.12235/E20250350
胸腔镜手术对结核性胸膜炎患者免疫功能及临床疗效的影响
Impact of thoracoscopic surgery on immune function and clinical efficacy in patients with tuberculous pleurisy
摘要
Abstract
Objective To explore the impact of thoracoscopic surgery on the immune function and clinical efficacy of patients with tuberculous pleurisy.Methods A retrospective analysis was conducted on the clinical data of 85 patients with tuberculous pleurisy who received and underwent surgical operations from July 2022 to January 2024.The patients were divided into the thoracotomy group(22 cases)and the thoracoscopic group(63 cases)according to different surgical methods.The perioperative indicators,pain degree,levels of serum inflammatory factors,liver and kidney functions,nutrition-related indicators,clinical efficacy and adverse reactions of the two groups were compared.Results The intraoperative blood loss and drainage volume in the thoracoscopic group were significantly less than those in the thoracotomy group,and the hospital stay,operation time and catheter insertion time were significantly shorter than those in the thoracotomy group.The differences were statistically significant(P<0.05).The visual analogue scale(VAS)scores of the thoracoscopic group at rest and during activity 24 hours after surgery were significantly lower than those of the thoracotomy group,and the differences were statistically significant(P<0.05).The postoperative 24 h C-reactive protein(CRP)in the thoracoscopic group was significantly lower than that in the thoracotomy group,and the difference was statistically significant(P<0.05).The levels of postoperative creatinine(Cr),aspartate transaminase(AST),and alanine transaminase(ALT)24 h after surgery in the thoracoscopic group were significantly lower than those in the thoracotomy group,and the differences were statistically significant(P<0.05).The prognostic nutritional index(PNI),albumin,hemoglobin and lymphocyte levels 24 h after surgery in the thoracoscopic group were significantly higher than those in the thoracotomy group,and the differences were statistically significant(P<0.05).The total effective rate of the thoracoscopic group was significantly higher than that of the thoracotomy group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in procalcitonin(PCT)and the total incidence of adverse reactions after surgery between the two groups(P>0.05).Conclusion For patients with tuberculous pleurisy,thoracoscopic surgery has more advantages than thoracotomy in reducing inflammatory responses,minimizing intraoperative blood loss,and improving nutritional status,and it is safe and effective.It is worth applying in clinical practice.关键词
胸腔镜手术/结核性胸膜炎/免疫功能/临床疗效/炎症因子/并发症Key words
thoracoscopic surgery/tuberculous pleurisy/immune function/clinical efficacy/inflammatory factors/complications分类
医药卫生引用本文复制引用
郭海涛,葛刚,李志强,田辉..胸腔镜手术对结核性胸膜炎患者免疫功能及临床疗效的影响[J].中国内镜杂志,2026,32(3):1-8,8.基金项目
国家自然科学基金面上项目(82472814) （82472814）
2025-2027年青岛市医疗卫生重点学科建设项目(58) （58）
