ABSTRACT
Objective To explore the feasibility and safety of uniportal video-assisted thoracoscopic surgery under non-intubated anesthesia with spontaneous respiration.Methods The clinical data in 35 cases of uniportal video-assisted thoracoscopic surgery under non-intubated anesthesia with spontaneous respiration implemented by same doctor and team in the Affiliated Nanjing Chest Hospital of Medical College,Southeast University from June 2016 to January 2017 were retrospectively analyzed.Results The operations were successfully completed in 35 cases,including 23 cases of lung bullae resection,6 cases of lung wedge resection,5 cases of pulmonary lobectomy and lymph nodes clearance,and 1 case of bilateral sympathectomy.The operative time was 20-106min,average(38.79 ± 26.45) min,intraoperative bleeding volume was 20-350 mL,average(57.14 ± 56.50) mL.No perioperative serious complications or death occurred.Conclusion Uniportal video-assisted thoracoscopic surgery technique under non-intubated anesthesia with spontaneous respiration is safe and feasible,and can be selectively used in partial patients.
ABSTRACT
Objective:To combine the detection of serum levels of adenosine deaminase (ADA) and T-cell spot test (T-spot.TB),and to explore their significances in diagnosis of pulmonary tuberculosis.Methods:159 patients suspected with pulmonary tuberculosis were selected and divided into pulmonary tuberculosis group and non-tuberculosis group (n=68);80 healthy people were randonly selected as healthy control group.The serum ADA levels and number of T-spot of the subjects in three groups were detected.Ther serum ADA levels and the positive rates of T-spot.TB in various groups and their sensitivities and specifities were compared. Results:The serum ADA level of the patients in pulmonary tuberculosis gruop was (22.10±6.60)U·L-1;those in non-tuberculosis group and healthy control group were (16.90±6.35)and (8.70±5.98)U·L-1;the serum ADA level in pulmonary tuberculosis group was significantly higher than those in non-tuberculosis group and heathy control group (P<0.05).The positive rate of serum ADA level in diagnosis of pulmonary tuberculosis was 56% and the T-spot.TB positive rate in diagnosis of pulmonary tuberculosis was 87.9%. Combined use of parallel test, the detection sensitivity was 91.2%;using the series of joint tests,the specificity was 94.6%.Conclusion:Combined detection of serum level of ADA and T-spot.TB can significantly improve the clinical diagnosis efficacy of pulmonary tuberculosis.