单孔胸腔镜肺癌根治术后胸腔引流管的选择  

Choice of pleural drainage tube after single port thoracoscopic for lung cancer

作　　者：王毅[1] 杨彦辉[1] 罗雷[1] 李晓亮[1] 谢晓阳[1] 

机构地区：[1]内江市第一人民医院胸心外科重庆医科大学内江附属医院,四川内江641000

出　　处：《中华肿瘤防治杂志》2017年第18期1310-1314,共5页Chinese Journal of Cancer Prevention and Treatment

摘　　要：目的单孔胸腔镜肺癌根治术加速肺癌患者术后快速康复,但术后引流管粗细是否影响患者术后快速康复尚不明确。本研究旨在探讨肺癌患者经单孔胸腔镜根治术后单16F引流管较28F胸引管行胸腔引流的临床优势。方法分析2014-10-01-2016-10-30四川省内江市第一人民医院胸外科连续收治的98例肺癌行单孔胸腔镜肺癌根治术患者,术后分别用单16F引流管(16F组,48例)和单28F胸引管(28F组,50例)行胸腔引流,分析术后皮下气肿、胸腔积液、积气、再置管率、术后1个月胸腔积液、引流量(1、2和3d)、引流持续时间、术后平均住院日、术后引流管(切口)拆线时间、切口愈合情况、切口满意度和VAS切口疼痛评分等。结果两组患者术后引流管相关并发症(胸腔积液、积气、再置管率和术后1个月胸腔积液)差异无统计学意义,P>0.05。16F组皮下气肿发生率为39.6%(19/48),高于28F组的16.0%(8/50),P=0.009。16F组术后1、2和3d引流量分别为(164.8±70.3)、(132.5±58.8)和(128.3±44.0)mL,均少于28F组的(273.8±98.7)、(195.8±60.3)和(169.2±46.1)mL,均P<0.001;16F组术后引流持续时间(54.1±14.1)h,短于28F组的(74.1±19.2)h,P<0.001;16F组术后平均住院日为(7.1±2.6)d,显著短于28F组的(8.2±1.7)d,P=0.015。16F组术后引流管(切口)拆线时间为(10.3±2.3)d,较28F组的(11.4±2.3)d更短,P=0.017;16F组拔管前后切口疼痛较28F组更轻(P<0.05),甲级愈合率及切口满意度更高(P<0.001)。结论单孔胸腔镜肺癌根治术后应用16F引流管是可行的,有利于肺癌患者术后快速康复。OBJECTIVE Single port thoracoscopic radical resection of lung cancer can help the patients recover quickly after the operation, whether the drainage tube thickness affects postoperative rapid recovery was remains unclear, However. The aim of this study was to investigate advantages of the lung cancer patients by single hole thoracoscopic for lung cancer using single 16F drainage tube and the 28F chest tube for thoracic drainage. METHODS Totally 98 cases of lung cancer from October 1, 2014 to October 30, 2016 of Sichuan province in Neijiang Hospital treated by using single hole thoracoscopic resection. Patients were treated with single 16F drainage tube （16F group, 48 cases） and single 28F thoracic duct （group 28F, 50 cases） post operation, analysising the postoperative subcutaneous emphysema, pleural effu- sion and pneumatosis, reqntubation rate, postoperative drainage of pleural effusion, lead discharge （1D, 2D, 3D）, drain- age duration, postoperative hospitalization days, postoperative drainage tube （incision） suture time, incision healing, in- cision satisfactionand VAS incision pain score. RESULTS There was no significant difference between the two groups in postoperative drainage tube related complications （pleural effusion, gas accumulation, re-intubation rate, and postopera- tive pleural effusion one month after operation） （P〈0.05）. The 16F group subcutaneous emphysema was higher than that in 28F group [（19, 39.6%） vs （8, 16%）, P〈0. 009）], while the drainage volume of group 16F [（164.8±70.3）, （132.5±58. 8）, （128. 3± 44. 0） mL]was less than that of group 28F three days before operation[（273. 8 ±98. 7）, （195.8±60.3） ,（169.2±46.1） mL,all P〈0. 001]. While 16F postoperative lead flow rate was less than that of 28F group （P〈0. 001）. The duration of postoperative drainage, average length of hospital stay were significantly shorter than that of 28F group [（54.1±14.1） h vs （74.1±19.2） h, P〈0. 001], [（7.1±2.6） d vs （8.2±1

关 键 词：单孔胸腔镜肺癌根治术 16F胸引管 快速康复 

分 类 号：R734.2[医药卫生—肿瘤]