Effect of intrathoracic injection of thrombin on oxidative stress and lung injury factors in patients with refractory pneumothorax

ZHANG Zhong-qiang; HU Li-li; CHEN Jun-li

doi:10.16048/j.issn.2095-5561.2025.01.03

Abstract：Objective To evaluate the efficacy of intrathoracic injection of thrombin and drainage tube suspension in refractory pneumothorax and its influence on oxidative stress,lung injury factors and prognosis.Methods A total of 92 patients with refractory pneumothorax admitted to the First Hospital of Handan City from January 2020 to December 2021 were selected.There were 54 males and 38 females,aged(59.89±5.38)years old,ranging from 33 to 85 years old.Patients were divided into control group(n=42)and study group(n=50)according to different treatment methods.Patients in control group received continuous closed thoracic drainage,while patients in study group received continuous closed thoracic drainage combined with intrathoracic injection of thrombin.The treatment effect,treatment-related indicators[leakage closure time,total intubation time,hospitalization time and visual analogue scale(VAS)score],patients'oxidative stress reaction[cortisol,superoxide dismutase(SOD),malondialdehyde],lung injury factors[pulmonary surfactant-related protein D(SP-D),human Clara cell protein(CC16)]levels and the clinical symptoms of the two groups were compared.Results The effective rate of treatment in the study group was higher than that in the control group.The time of leakage closure,total catheter time,hospitalization time and VAS score of 72 hours after operation were better than those of the control group,and the differences were statistically significant(P＜0.05).After 3 weeks of treatment,the levels of serum cortisol and malondialdehyde in the study group were lower than those in the control group.The SOD level was higher than that of the control group.Serum SP-D was lower than that of control group;The level of CC16 was higher than that of the control group.After one year of treatment,the recurrence rate was lower than that of the control group,the differences were statistically significant(P＜0.05).There was no significant difference in the incidence of adverse reactions between the two groups,the difference was not statistically significant(P＞0.05).Conclusion Intrathoracic injected thrombin on the basis of continuous closed thoracic drainage can further improve the effect of refractory pneumothorax,help to reduce pain,reduce oxidative stress and lung injury,prevent recurrence.