单胸腔引流管在肺癌术后快速康复中的应用  

Single Chest Tube Application Promotes Fast Track Recovery after Lung Cancer Resection

作　　者：韩兆杰 宋志芳[1] 苏建华[2] 刘伦旭[1] 车国卫[1] 

机构地区：[1]四川大学华西医院胸外科,成都610041 [2]四川大学华西医院康复科,成都610041

出　　处：《中国胸心血管外科临床杂志》2014年第1期7-10,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

基　　金：四川省科技厅资助项目(2009SZ0169)~~

摘　　要：目的比较肺癌肺叶切除术后单、双胸腔引流管的临床效果及单胸腔引流管在快速康复中的应用。方法纳入2009年3～12月四川大学华西医院93例肺癌患者，将其分为单胸腔引流管组[46例，男39例、女7例，年龄（58．4±9．5）岁和双胸腔引流管组（47例，男32例、女15例，年龄（58．2±9．0）岁]。观察两组的引流量、引流管持续时间、术后住院时间、拔管后积气与积液。结果双胸腔引流管组中全胸腔镜肺叶切除术（video-assistedthoracicsurgery，VATS）患者数显著高于单胸腔引流管组，而开胸手术数显著少于单胸腔引流管组（P〈0．05）。双胸腔引流管组引流量显著多于单胸腔引流管组[（824．4±612．5）mlVS．（510．7±406．7）ml，P〈0．05]。单胸腔引流管组与双胸腔引流管组术后带管时间、住院时间、皮下气肿、胸腔积气、积液和再次置管差异均无统计学意义（P〉0．05）。结论肺癌肺叶切除术单胸腔引流管引流效果优于或与双胸腔引流管效果相当，且带管时间有缩短的趋势。Objective To compare clinical results between single and double chest tube applications after lung cancer resection, and explore the role of single chest tube in postoperative fast track recovery. Method Ninety-three patients with lung cancer who underwent lobectomy between March and December of 2009 in West China Hospital of Siehuan University were included in this study. All the patients were divided into a single-tube group including 46 patients （ 39 males and 7 females） with their age of 58.4±9.5 years, and a double-tube group including 47 patients （32 males and 15 females） with their age of 58.2± 9.0 years. Drainage amount, duration, postoperative hospital stay, and incidences ofpneumothorax and pleural effusion after removal of chest tubes were compared between the 2 groups. Results The percentage of patients undergoing complete video-assisted thoracic surgery （VATS） of the double-tube group was significantly higher than that of the single-tube group, and the percentage of patients undergoing thoracotomy of the double-tube group was significantly lower than that of the single- tube group （P 〈 0.05 ）. Drainage amount of the double-tube group was significantly larger than that of the single-tube group （824.4± 612.5 ml vs. 510.7± 406.7 ml, P 〈 0.05 ）. There was no statistical difference in drainage duration, postoperative hospital stay, the incidences of subcutaneous emphysema, pneumothorax, pleural effusion or re-insertion of chest drain between the 2 groups （P 〉 0.05）. Conclusion Clinical results of single chest tube is better than or equivalent to those of double chest tubes after lung cancer resection, and drainage duration of single chest tube application might be shorter.

关 键 词：胸腔引流管 肺叶切除术 肺肿瘤 

分 类 号：R655.3[医药卫生—外科学]