单根细管引流联合早期拔管在肺癌患者胸腔镜肺叶切除术的应用  

Application of single fine chest drainage tube combined with early extubation tactics in patients undergoing thoracoscopic lobectomy for lung cancer

作　　者：闵波 朱逸 王成祥 王岩 马海涛[2] MIN Bo;ZHU Yi;WANG Chengxiang(Department of Thoracic Surgery,Affiliated Huai'an Hospital,Xuzhou Medical University,Huai'an 223001,CHINA)

机构地区：[1]徐州医科大学附属淮安医院(淮安市第二人民医院)胸外科,江苏淮安223001 [2]苏州大学附属第一医院胸外科

出　　处：《江苏医药》2019年第11期1100-1104,共5页Jiangsu Medical Journal

基　　金：国家自然科学基金(81672281)

摘　　要：目的观察单根细管引流联合早期拔管在肺癌患者胸腔镜肺叶切除术应用的效果。方法接受胸腔镜肺叶切除术的肺癌患者113例分为三组:A组42例,术中放置单根20 F引流管,且24 h引流量≤350 ml时拔管;B组34例,术中放置单根20 F引流管,且24 h引流量≤100 ml时拔管;C组37例,术中放置单根28 F引流管,且24 h引流量≤100 ml时拔管。比较三组临床疗效及并发症发生情况。结果A组术后引流时间和住院天数短于B、C组(P<0.01)。A组术后24、48 h和2周VAS疼痛评分均低于C组(P<0.05或P<0.01),且B组术后48 h和2周VAS疼痛评分均低于C组(P<0.05或P<0.01)。A、B组肺不张和肺部感染发生率低于C组(P<0.05)。结论肺癌患者胸腔镜肺叶切除术后采用单根细引流管联合术后早期拔管,有助于缩短术后引流时间和住院时间,减轻疼痛并促进康复。Objective To observe the application efficiency of single fine chest drainage tube combined with early extubation tactics in the patients undergoing thoracoscopic lobectomy for lung cancer.Methods A total of 113 patients with lung cancer was undergoing thoracoscopic lobectomy for lung cancer.A single 20 F drainage tube was placed during operation in group A(42 cases),which was removed when drainage volume in 24 hours was≤350 ml.A single 20 F drainage tube was placed during operation in group B(34 cases),which was removed when drainage volume in 24 hours was≤100 ml.A single 28 F drainage tube was placed during operation in group C(37 cases),which was removed when drainage volume in 24 hours was≤100 ml.Clinical efficacy and complications were compared among three groups.Results Postoperative drainage time and hospital stay in group A were shorter than those in groups of B and C(P<0.01).The VAS pain scores in the 24^th and 48^th hour and 2^nd week after operation in group A were lower than those in group C(P<0.05 or P<0.01),which in the 48^th hour and 2^nd week after operation in group B were lower than those in group C(P<0.05 or P<0.01).The incidence rates of atelectasis and pulmonary infection in groups of A and B were lower than those in group C(P<0.05).Conclusion The application of single fine chest drainage tube combined with early extubation tactics is helpful to reduce postoperative pain,shorten hospital stay and promote recovery in the patients undergoing thoracoscopic lobectomy for lung cancer.

关 键 词：胸腔引流 胸腔镜肺癌根治术 肺癌 

分 类 号：R734[医药卫生—肿瘤]