左右侧胸腔镜肺上叶切除术后胸腔引流情况的对照研究  

A Controlled Study on Postoperative Thoracic Drainage After Thoracoscopic Lobectomy Between Left and Right Superior Lobe

作　　者：查鹏 陈艳艳[1] 张蔚萱 梁正[1] Cha Peng;Chen Yanyan;Zhang Weixuan(Department of Thoracic Surgery, Peking University International Hospital, Beijing 102206, China)

机构地区：[1]北京大学国际医院胸外科,北京102206

出　　处：《中国微创外科杂志》2021年第3期253-256,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：北京大学国际医院院内课题(YN2019QN09)。

摘　　要：目的对比左右侧胸腔镜肺上叶切除术后胸腔引流情况,指导优化胸腔引流策略。方法回顾性分析2016年1月~2020年9月53例三孔胸腔镜肺上叶切除术资料,左肺上叶30例,右肺上叶23例,术后均采用双管引流。比较2组术后引流时间、肺复张时间、拔管延迟(引流>7天)比例。结果53例均顺利完成手术。2组手术时间、麻醉时间、术中出血量差异无统计学意义(P>0.05)。左肺上叶术后引流时间[(9.6±7.7)d]长于右肺上叶[(7.3±4.5)d],但差异无统计学意义(t=1.290,P=0.203)。左肺上叶肺复张时间[(6.0±8.4)d]显著长于右肺上叶[(2.6±2.8)d](t=2.123,P=0.041)。2组术后引流总量差异无统计学意义(P>0.05)。左肺上叶拔管延迟比例[43.3%(13/30)]高于右肺上叶[26.1%(6/23)],但差异无统计学意义(χ2=1.684,P=0.194)。结论胸腔镜右肺上叶切除术后肺复张快,可以考虑优化引流策略;胸腔镜左肺上叶切除术后仍有必要采用双管引流。Objective To compare the postoperative thoracic drainage in patients receiving thoracoscopic lobectomy between left and right superior lobe,in order to guide the improvement of thoracic drainage strategy.Methods Clinical data of 53 patients who underwent three-port thoracoscopic lobectomy of superior lobe from January 2016 to September 2020,including 30 patients of left superior lobe and 23 patients of right superior lobe,all of whom accepted double tube thoracic drainage after operation,were retrospectively analyzed.Measurements including the time of postoperative drainage,the time of lung recruitment and the rate of delayed extubation(postoperative drainage time>7 d)were compared between the two groups.Results All the 53 patients successfully underwent thoracoscopic lobectomy of superior lobe.The differences in operation time,anesthesia time and the amount of intraoperative blood loss between the two groups were not statistically significant(P>0.05).The postoperative drainage time of left superior lobe group[(9.6±7.7)d]was longer than that of right superior lobe group[(7.3±4.5)d],but the difference was not statistically significant(t=1.290,P=0.203).The time of lung recruitment in the left superior lobe group[(6.0±8.4)d]was significantly longer than that in the right superior lobe group[(2.6±2.8)d,t=2.123,P=0.041].The difference in the total amount of postoperative drainage between the two groups was not statistically significant(P>0.05).The rate of delayed extubation in the left superior lobe group was 43.3%(13/30),which was higher than that in the right superior lobe group[26.1%(6/23)],but the difference was not statistically significant(χ2=1.684,P=0.194).Conclusion Compared with the left superior lobe,the lung recruitment after thoracoscopic lobectomy of right superior lobe resection is faster,so the improvement of thoracic drainage strategy can be considered,while it is still necessary to adopt double tube thoracic drainage after thoracoscopic lobectomy of left superior lobe.

关 键 词：电视胸腔镜手术 肺叶切除术 胸腔引流 

分 类 号：R73[医药卫生—肿瘤]