胸腔引流管引流时间对纵隔肿瘤胸腔镜切除术后患者恢复的影响  

The Effects of Thoracic Drainage Time on Patient' Recovery with Mediastinal Tumor after Videoassisted Thoracoscopic Surgery

作　　者：潘小明[1] 韦涌初[1] 

机构地区：[1]南宁市第二人民医院心胸外科,南宁530031

出　　处：《医学综述》2015年第23期4354-4355,4358,共3页Medical Recapitulate

摘　　要：目的探讨胸腔引流管不同引流时间对纵隔肿瘤胸腔镜切除术后患者恢复的作用。方法收集2010年1月至2014年1月南宁市第二人民医院72例纵隔肿瘤患者,依据随机数字表法分为A、B和C三组。A组患者24例,接受胸腔镜切除术,术后患者引流管置管时间为3 d;B组患者25例,接受胸腔镜切除术,当存在引流管拔管指征时拔管;C组患者23例,接受传统开胸手术;当存在引流管拔管指征时拔管。分别观察B和C组患者所需的拔管时间,三组患者的住院时间和发生感染、呼吸衰竭、二次返院及死亡的患者比例。结果 A组、B组、C组三组患者的引流管时间分别为(4.22±1.04)d、(4.75±1.18)d、(8.13±2.05)d,差异有统计学意义(P<0.05),以C组手术引流时间最长;A组和B组患者住院时间、感染的发生率、呼吸衰竭发生率和二次返院率均要显著低于C组[(7.16±1.24)d、(9.07±2.48)d比(12.14±3.23)d;12.5%(3/24)、8.0%(2/25)比34.8%(8/23);0%、0%比13.0%(3/23);0%、0%比17.4%(4/23)](P<0.05);A组和B组患者的感染发生率、呼吸衰竭发生率和二次返院率差异无统计学意义(P>0.05),而两组的住院时间差异有统计学意义(P<0.05),三组患者的病死率差异无统计学意义(P>0.05)。结论胸腔镜下切除纵隔肿瘤比传统开胸手术更利于患者术后的恢复,同时胸腔镜手术能早期拔除引流管,缩短患者的住院时间。Objective To explore the effects of thoracic drainage time on patient＇ recovery with mediasfinal tumor after video-assisted thoracoscopic surgery. Methods Total of 72 cases with mediastinal tumor from the Second Hospital of Nanning city during Jan. 2010 and Jan. 2014 were included as group A,group B and group C according to random number table method. Group A （24 cases） received video-assisted thoracoscopic surgery and thoracic drainage for three days;group B （25 cases） received video-assisted thoracoscopic surgery and thoracic drainage tube was pulled out when there was such indication;group C （23 cases） received traditional thoracotomy and the thoracic drainage tube was pulled out when there was such indication. The thoracic drainage tube pulling time of group B and C was recorded. Length of hospital stay, respiratory failure, infection and returning visit cases and death proportion of the three groups were observed. Results Drainage time of group A,group B and group C was （4. 22 ±1.04） d, （4.75 ± 1.18） d, （8. 13 ±2.05 ） d （ P 〈 0. 05 ）, group C was the longest among the three groups. Length of hospital stay, proportion of respiratory failure,infection incidence and returning visit cases of group A and group B were significantly lower than groupC[（7.16±1.24） d,（9.07 ±2.48） d vs （12. 14±3.23） d;12.5%（3/24）,8.0% （2/25）vs 34. 8% （8/23） ;0% ,0% vs 13.0% （3/23） ;0% ,0% vs 17.4% （4/23）, P 〈 0.05 ]. There was no statistically significant difference in respiratory failure, infection incidence and returning visit cases between group A and group B （ P 〉 0.05 ）, while difference in length of hospital stay was statistically significant （ P 〈 0. 05 ）, the difference in death was not statistically significant（P 〉 0. 05 ）. Conclusion Video-assisted thoracoscopic surgery is better than traditional thoracotomy to treat patients with mediastinal tumor. Pulling out thoracic drainage tube early can shorten length of hospital stay of the patie

关 键 词：纵隔肿瘤 胸腔镜 胸腔引流 

分 类 号：R473[医药卫生—护理学]