目的 探讨腔镜手术治疗老年肺癌的疗效及对肺功能的影响。方法 我们纳入90例老年肺癌患者作为研究对象,随机抽签分为2组,各45例。观察组45例行胸腔镜肺癌切除术,对照组45例行传统开胸肺癌切除术。比较两组患者手术时间、术中出血量、胸腔引流时间、淋巴结清扫数量、术后住院时间、疼痛评分、肺功能及术后并发症情况。结果 两组手术时间、淋巴结清扫数量无差异(P>0.05);观察组术后胸腔引流时间、术中出血量、疼痛评分、住院时间少于对照组(P＜0.05)。观察组术后并发症总发生率低于对照组(P＜0.05)。观察组术后一秒用力呼气容积、用力肺活量、肺活量、一秒用力呼气容积与用力肺活量比值恢复情况优于对照组(P＜0.05)。结论 腔镜微创手术用于老年肺癌患者能够显著降低围术期并发症,缩短患者术后恢复时间,且有助于改善肺功能。

Objective To investigate the efficacy and safety of endoscopic surgery in the treatment of elderly patients with lung cancer. Methods 90 elderly patients with lung cancer in our hospital were divided into two groups,45 cases in each group. The observation group was treated with thoracoscopic lung resection in 45 cases, the control group of 45 cases received conventional open lung cancer resection. The operation time, intraoperative blood loss, thoracic drainage time, lymph node dissection, postoperative hospital stay, pain score, pulmonary function assessment and postoperative complications were compared. Results There were no significant differences in the operation time and lymph node dissection between the two groups (P>0.05). The thoracic drainage time,intraoperative blood loss pain score and hospitalization time in the observation group were lower than those in the control group(P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group(P<0.05). The forced expiratory volume, forced vital capacity, vital capacity, one-second forced expiratory volume and forced vital capacity of the observation group were better than those in the control group after operation(P<0.05). Conclusion Endoscopic minimally invasive surgery may significantly reduce perioperative complications in elderly patients with lung cancer, shorten the postoperative recovery time and improve lung function.

       目的   探讨支气管镜灌洗用于儿童重症肺部感染合并肺实变的治疗效果及对CT特征、肺功能的影响。方法   选取2022年5月—2024年5月铜仁市人民医院收治的100例重症肺部感染合并肺实变患儿开展前瞻性研究，应用随机数表法分为对照组和观察组，每组各50例。对照组患儿采取常规治疗，观察组则采取常规治疗加支气管镜灌洗治疗。对比其临床疗效，治疗前后炎症因子、CT特征及肺功能变化。结果   观察组治疗总有效率高于对照组（P＜0.05）；治疗后观察组患儿白细胞计数（10.36±2.52）×10⁹ /L、白细胞介素-6（20.57±5.05）ng/L、C反应蛋白（13.12±2.64）mg/L、降钙素原（101.62±12.16）pg/L均低于对照组白细胞计数（13.25±3.32）×10⁹ /L、白细胞介素-6（31.69±4.11）ng/L、C反应蛋白（16.16±4.44）mg/L、降钙素原（113.46±18.11）pg/L（P＜0.05）；治疗后两组患儿胸腔积液、支气管壁增厚、空气支气管征、肺部实变、磨玻璃影等相关CT影像特征占比下降，且观察组低于对照组（P＜0.05）；治疗后两组患儿呼气流量峰值水平均升高，观察组（90.67±18.45）L/s高于对照组（81.27±17.69）L/s，用力肺活量水平均更高，观察组（3.33±0.68）L高于对照组（2.68±0.25）L（P＜0.05）。结论   针对儿童重症肺部感染合并肺实变，在常规治疗基础上增加支气管镜灌洗可提升临床疗效，减轻机体炎症反应，改善胸部CT各种表现及肺功能。

        Objective  To explore the therapeutic effects of bronchoalveolar lavage in children with  severe pulmonary infection complicated by lung consolidation and its impact on CT features and pulmonary function．Methods A prospective study was conducted on 100 children with severe pulmonary infection complicated with pulmonary consolidation in a hospital from May 2022 to May 2024．They were randomly divided into observation group and control group using a random number table method，50 cases in each group．The control group of children received routine treatment，and the observation group received conventional treatment plus bronchoalvelar lavage．Clinical efficacy，inflammatory factors，CT features，and alterations in pulmonary function before and after therapy were compared．Results  The total effective rate of the observation group was higher than that of the control group（P＜0.05）．After treatment，the white blood cell count（10.36±2.52）×10⁹ /L，interleukin-6（20.57±5.05）ng/L，C-reactive protein（13.12±2.64）mg/L，and procalcitonin（101.62±12.16）pg/L in the observation group were all lower than those in the control group（13.25±3.32）×10⁹ /L，interleukin-6（31.69±4.11）ng/L，C-reactive protein（16.16±4.44）mg/L，and procalcitonin（113.46±18.11）pg/L（P＜0.05）．After treatment，the proportion of CT imaging features such as pleural effusion，bronchial wall thickening，air bronchogram sign，lung consolidation，ground glass opacities，decreased in both groups of children，and the observation group was lower than the control group（P＜0.05）．After treatment，the peak levels of expiratory flow in both groups of children increased，with the observation group（90.67±18.45）L/s higher than the control group（81.27±17.69）L/s．The forced vital capacity levels were also higher，with the observation group（3.33±0.68）L higher than the control group（2.68±0.25）L（P＜0.05）．Conclusions  Adding bronchoalvelar lavage to routine treatment for children with severe pulmonary infection complicated with pulmonary consolidation can improve their clinical efficacy，alleviate inflammatory reactions，and improve various chest CT manifestations and lung function．