目的 分析 CT 引导下胸腔引流微管对肺气肿合并巨大肺大疱患者的临床疗效及安全性。 方法 选择肺气肿合并巨大肺大疱患者 74 例，其中胸腔镜手术 30 例（对照组），胸腔引流微管 44 例（观察 组）。比较两组患者手术时间、出血量、切口感染、术后引流时间、术后住院时间、带管时间和肺复张时 间，术后 1 d、3 d 和 7 d 疼痛视觉模拟量表（VAS）评分，肺大疱消失时间和复发率。术前和术后 2 d C 反应 蛋白（CRP）和白细胞介素⁃6（IL⁃6）水平，术前和术后 1 d 动脉血氧分压（PaO2）、末梢血氧饱和度（SaO2）和 第一秒用力呼气量（FEV1）。结果 观察组手术时间、术后住院时间和肺复张时间比对照组缩短，带管时 间比对照组延长，出血量减少，术后 1 d、3 d 疼痛 VAS 评分均低于对照组，术后血清 CRP 和 IL⁃6 水平低于 对照组，术后 PaO2、SaO2和 FEV1 均高于对照组（P < 0.05）。结论 CT 引导下胸腔引流微管置入治疗肺气 肿合并巨大肺大疱有较好的临床疗效和安全性，比胸腔镜切除术创伤更小、疼痛和炎症反应更轻、肺功能改善更佳。

Objective To analyze the clinical efficacy and safety of CT⁃guided thoracic drainage microtu⁃ bule for patients of emphysema complicated with giant pulmonary bullae. Methods A total of 74 patients of emphysema with giant pulmonary bullae into our hospitalwerechosed. As the control group，30 patients underwent surgical thoracoscopic surgery，while the observation group included 44 patients who underwent CT⁃guided place⁃ ment of thoracic drainage microtubules. The operation indexes between the two groups were compared，including operation time，bleeding volume，incision infection，postoperative drainage time，postoperative stay ⁃in hospital days，tube time and lung re⁃expansion time，pain visual analogue scale（VAS）score 1 d，3 d and 7 d after opera⁃ tion，disappearance time and recurrence rate of giant pulmonary bullae. The levels of serum inflammatoryfactors C⁃reactive protein（CRP）and interleukin⁃6（IL⁃6）before and 2 d after operation，as well as arterial partial pressure （PaO2），peripheral oxygen saturation（SaO2）and forced expiratory volume in the first second（FEV1）before and 1 d after operation. Results The observation group′s operation time，hospital stay days，and lung re⁃expansion time were shorter than the control group′s，tube time was longer，bleeding volume was less，pain VAS scores 1 d，3 d after operation were lower than the control group，serum CRP and IL⁃6 levels were lower，and postoperative PaO2， SaO2，and FEV1 were higher（P < 0.05）. Conclusion CT ⁃ guided thoracic drainage microtubule placement improves clinical efficacy and safety in emphysema with giant pulmonary bullae.It causes less trauma，less pain and inflammation，and improves pulmonary function more than thoracoscopic resection.