胸腔镜肺大疱切除术对单侧自发性气胸患者术后切口疼痛程度的影响  

Study on the Effect of Thoracoscopic Pulmonary Bulbar Resection on Postoperative Incision Pain in Patients with Unilateral Spontaneous Pneumothorax

作　　者：彭勇 张广云 江振强 周衍彬 PENG Yong;ZHANG Guangyun;JIANG Zhenqiang;ZHOU Yanbin(Department of Thoracic Surgery,Heyuan People's Hospital,Heyuan 517000,China)

机构地区：[1]河源市人民医院胸外科,广东河源517000

出　　处：《中国医药指南》2020年第22期91-92,共2页Guide of China Medicine

摘　　要：目的探讨胸腔镜肺大疱切除术对单侧自发性气胸患者术后切口疼痛程度的影响。方法将2016年1月至2019年1月在我院胸外科治疗的107例单侧自发性气胸患者随机分为两组,观察组(n=55)使用单孔胸腔镜肺大疱切除术,对照组(n=52)使用双孔胸腔镜肺大疱切除术,比较两组患者的各项手术指标、术后疼痛情况、并发症发生率、生活质量。结果观察组患者手术时间、术中出血量、肺复张率与对照组相比无明显差异(P>0.05),但观察组患者切口长度、曲马多用量、术后引流量、住院时间明显少于对照组(P<0.05);观察组患者术后1、2、3 d的切口VAS疼痛评分明显低于对照组(P<0.05);观察组患者切口感染、切口麻木、自发性气胸、自发性血气胸、肺不张等并发症发生率明显低于对照组(P<0.05);观察组患者术后GQOL-74评分明显高于对照组(P<0.05)。结论胸腔镜肺大疱切除术对单侧自发性气胸效果显著,创伤小,术后疼痛轻,并发症发生率低,恢复质量好,能有效提高患者的生活质量。Objective To investigate the effect of thoracoscopic pulmonary bullectomy on the postoperative incision pain in patients with unilateral spontaneous pneumothorax.Methods From January 2016 to January 2019 in our hospital thoracic surgery for the treatment of 107 patients with unilateral spontaneous pneumothorax were randomly divided into two groups,the observation group(n=55)was used single-hole thoracoscopic pneumonectomy,the control group(n=52)was used double-hole thoracoscopic pneumonectomy,compared two groups of patients the operation indexes,postoperative pain,complications,quality of life.Results There were no significant differences between the observation group and the control group in operation time,intraoperative blood loss,and lung retension rate(P>0.05),but the incision length,tramadol dosage,postoperative drainage volume,and hospitalization time in the observation group were significantly less than those in the control group(P<0.05).The VAS pain scores of incision 1 d,2 d and 3 d after surgery in the observation group were significantly lower than those in the control group(P<0.05).The incidences of incisional infection,incision numbness,spontaneous pneumothorax,spontaneous hemopneumothorax,atelectasis and other complications in the observation group were significantly lower than those in the control group(P<0.05).The postoperative GQOL-74 score of the observation group was significantly higher than that of the control group(P<0.05).Conclusion Thoracoscopic pulmonary bulbar resection has significant effect on unilateral spontaneous pneumothorax,less trauma,less postoperative pain,lower incidence of complications,good quality of recovery,can effectively improve the quality of life,and has positive clinical significance.

关 键 词：单侧自发性气胸 胸腔镜肺大疱切除术 术后切口疼痛 并发症 生活质量 

分 类 号：R561.4[医药卫生—呼吸系统]