1.Dual-Center Clinical Study on Detection of Intraoperative Air Leak During Pulmonary Resection Using Nebulized Indocyanine Green
Zhenfan WANG ; Songjing ZHAO ; Ruiheng JIANG ; Zhuoer CUI ; Yingtai CHEN ; Jian ZHOU ; Kezhong CHEN ; Yun LI
Medical Journal of Peking Union Medical College Hospital 2026;17(3):646-651
To evaluate the clinical value of nebulized indocyanine green(ICG) combined with near-infrared fluorescence imaging for intraoperative detection of air leaks during pulmonary resection. This was a two-center randomized controlled trial enrolling patients undergoing thoracoscopic pulmonary resection. After enrollment, patients were randomly divided into an experimental group and a control group. The experimental group received nebulized ICG and fluorescence imaging in addition to the conventional water immersion test, while the control group underwent the water immersion test alone. Intraoperative air leak detection and postoperative air leak incidence were compared between the two groups. Multivariable logistic regression analysis was performed to assess the association between ICG nebulization intervention and postoperative air leaks after adjusting for confounding factors including age, sex, smoking history, history of respiratory disease, surgical procedure, and study center. A total of 181 patients were enrolled(90 in the experimental group, 91 in the control group). The experimental group showed significantly higher intraoperative air leak detection rate(37.8% Nebulized ICG combined with near-infrared fluorescence imaging significantly improves intraoperative detection of air leaks, reduces the incidence of postoperative air leaks, and shortens chest tube duration. This technique is convenient, safe, and holds important clinical value for application.
2.Clinical study of self-made Huatan Prescription combined with conventional western medicine therapy in the treatment of severe pneumonia of phlegm turbidity
Lin TANG ; Songjing ZHOU ; Zongbao LI
International Journal of Traditional Chinese Medicine 2023;45(5):553-557
Objective:To evaluate the clinical efficacy of external therapy with self-made Huatan Prescription combined with conventional western medicine therapy in the treatment of severe pneumonia of phlegm turbidity obstructing lung.Methods:Randomized controlled trial. A total of 114 patients with severe pneumonia of phlegm turbidity obstructing lung in the hospital between July 2020 and December 2021 were enrolled in this study. The patients were divided into two groups by the random number table method, with 57 in each group. On the basis of conventional western medicine therapy, the treatment group was given external therapy of self-made Huatan Prescription, and the control group was given the placebo. Both groups were applied continuously for 5 days. The TCM syndromes were scored before and after treatment. The disease severity was evaluated by Sequential Organ Failure Assessment (SOFA) and Acute Physiology and Chronic Health Evaluation Ⅱ(APACHE Ⅱ). The levels of WBC and procalcitonin (PCT) were detected by automatic blood analyzer. The levels of serum CRP and IL-6 were detected by ELISA. The adverse reactions during treatment were recorded and the clinical efficacy was evaluated.Results:After treatment, the total respinse rate was 92.98% (53/57) in treatment group and was 70.18% (40/57) in control group ( χ2=9.87, P=0.002). The scores of fever, unconsciousness, cough and expectoration, nausea and vomiting, tongue coating and pulse and total score in treatment group were significantly lower than those in the control group ( t=8.95, 7.30, 6.93, 7.37, 12.02, 12.59, 14.29, P<0.01). SOFA (18.12±3.55 vs. 21.46±3.58, t=5.00) and APACHE Ⅱ (13.39±2.72 vs. 16.52±3.13, t=5.70) in treatment group were significantly lower than those in the control group ( P<0.01). The levels of WBC [(11.12±1.61) ×10 9/L vs. (12.69±1.82) ×10 9/L, t=4.88], PCT [(3.72±0.81) μg/L vs. (5.19±0.92) μg/L, t=9.05], serum CRP [(62.09±11.41) mg/L vs. (91.77±15.54) mg/L, t=11.62] and IL-6 [(193.14±32.28) ng/L vs. (235.68±38.75) ng/L, t=6.37] in treatment group were significantly lower than those in the control group ( P<0.01). During treatment, there were no obvious adverse reactions in both groups. Conclusion:Self-made Huatan Prescription external therapy combined with conventional western medicine therapy can improve the clinical symptoms, inhibit the inflammatory response, relieve the disease condition and improve the prognosis of patients with severe pneumonia of phlegm turbidity obstructing lung safely.
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