老年患者全胸腔镜肺叶切除术后去止血治疗的安全性研究  

Clinic Study on the Safety of Non-application of Hemostatic Agents after Thoiacoscopic Lobectomy in Senile Patients

作　　者：李晓平[1] 任海霞[2] 王旭晖[1] 杨波[1] 李磊[1] 张亮[1] 张卫东[1] 

机构地区：[1]天津市第一中心医院胸外科,天津300192 [2]天津市第一中心医院药剂科,天津300192

出　　处：《现代生物医学进展》2016年第20期3869-3872,共4页Progress in Modern Biomedicine

基　　金：天津市卫生局面上基金项目(2013ky09)

摘　　要：目的:探讨全胸腔镜肺叶切除术后老年患者不应用止血药物的安全性。方法:回顾性分析65例成功施行全胸腔镜肺叶切除手术老年患者(年龄≥65周岁),按术后不同治疗方案分为研究组29例(术后未应用任何止血药物)及对照组36例(常规应用止血药物),对比两组患者术后胸腔引流情况、拔除引流管时间、住院时间、相关不良反应及并发症,评价全胸腔镜肺叶切除术后老年患者不应用止血药物的安全可靠性。结果:研究组术后24 h(310.6±54.6 m LVS 262.3±67.2 mL,P<0.05)及48 h(225.4±47.3m LVS 195.5±66.4 mL,P<0.05)胸腔引流量高于对照组,拔除引流管时间(4.23±2.84天VS 4.02±3.37天,P>0.05)、住院时间(6.82±2.23天V S 6.53±3.21天,P>0.05)及发生出血(3例V S 2例,P>0.05)、栓塞风险均无显著差异,但应用止血药物增加了药物自身相关不良反应的风险,对照组中应用贝瑞凝止血治疗后,11例患者出现了消化道不适反应,1例患者出现头痛。结论:全胸腔镜肺叶切除术后老年患者,经术中严密止血后术后不应用止血药物是安全可靠的。Objective： To evaluate the safety and reliability without hemostatic agents after Video-Assisted Thoracic Surgery （VATS） lobectomy in the elderly patients. Methods： 65 cases of elderly patients （older than 65 years） with VATS lobectomy resection were randomly divided into two groups, the 29 patients in study group were treated without applying any hemostatic drugs and the 36 patients in control group were given postoperative hemostatic drugs. The pleural drainage, tube removal time, hospitalization time, related adverse reactions and complications, were detected and compared between two groups. Results： The volume of pleural drainage in postoperative 24h and 48h was higher in study group than that of the control group （P〈0.05）, and the removal time of chest drainage, hospitalization time and occurrence of hemorrhage, embolic risk had no significant difference between two groups （P〉0.05）, but the application of hemostatic agents increased the risk of adverse drug reactions, there were gastrointestinal discomfort in 11 cases and headache in one patient. Conclusions： Non-application of hemostatic agents in elderly patients after VATS lobectomy is safe and reliable.

关 键 词：胸腔镜 肺叶切除 老年 止血 

分 类 号：R619.1[医药卫生—外科学]