双腔不等长胸腔引流管并微负压吸引在单孔胸腔镜肺叶切除术后的临床应用  

Clinical application of double cavity unequal thoracic drainage tube with micro-negative pressure suction after uniportal VATS pulmonary lobectomy

作　　者：姜威[1] 张宁宁[2] 曲博[1] 张敏 周志明[1] JIANG Wei;ZHANG Ningning;QU Bo;ZHANG Min;ZHOU Zhiming(Department of Thoracic Surgery,The Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,China;Hospital Infection-Control Department,The Central Hospital Affiliated to Shenyang Medical College,Shenyang 110024,China)

机构地区：[1]沈阳医学院附属中心医院胸外科,辽宁沈阳110024 [2]沈阳医学院附属中心医院院感科,辽宁沈阳110024

出　　处：《沈阳医学院学报》2021年第6期548-551,共4页Journal of Shenyang Medical College

摘　　要：目的:探讨在单操作孔电视胸腔镜下肺叶切除术中术后应用双腔不等长胸腔引流管并微负压吸引代替传统胸腔闭式引流管的可行性。方法:选择2018年8月至2019年12月我院收治的电视胸腔镜下行单操作孔肺叶切除患者80例,随机分为试验组和对照组,各40例,分别应用双腔不等长胸腔引流管(28 Fr管径)并联合微负压吸引、常规28 Fr传统胸腔引流管进行胸腔引流。比较2组患者的手术时间、术中出血量、术后创口疼痛(VAS)评分、每日胸腔引流量及持续胸腔引流时间、术后并发症(皮下气肿、漏气、胸腔内积液积气)及拔管后并发症(液气胸复发、引流口渗出)、术后住院时间等指标。结果:试验组患者术后VAS评分、术后皮下气肿、术后胸腔内积液积气等发生率及术后住院时间均显著少于对照组;试验组患者持续胸腔引流时间、拔管后液气胸复发的比例均显著少于对照组,差异均有统计学意义(P<0.05)。结论:双腔不等长胸腔引流管联合微负压吸引代替传统单管胸腔引流管在单孔电视胸腔镜下肺叶切除后的临床应用中具有术后胸部疼痛轻、可有效防止管腔堵塞,且能加速术后胸腔内积液积气的排出、促进残肺尽早复张、减少术后住院时间、明显减少术后胸膜腔残留积液积气等。Objective:To investigate the feasibility of application of double cavity unequal thoracic drainage tube with micronegative pressure suction in uniportal VATS lobectomy instead of traditional chest drainage tube.Methods:A total of 80 patients from Aug 2018 to Dec 2019 underwent the thoracoscope lobectomy in our hospital were randomly divided into the treatment group and the control group,40 cases in each group.The treatment group received double cavity unequal thoracic drainage tube with micronegative pressure suction.The control group received conventional 28 Fr chesttube thoracic drainage.The operation time,intraoperative blood loss,postoperative pain(VAS score),daily drainage volume,drainage time,postoperative complications and post-extubation complications were compared between the two groups.Result:In the treatment group,postoperative VAS score,postoperative related complication incidence and postoperative hospitalization days,drainage time,and incidence of pleural effusion and gas accumulation after extubation were significantly less than those in the control group(P<0.05).Conclusions:The clinical application of double cavity unequal thoracic drainage tube combined with micro-negative pressure suction instead of traditional single tube thoracic drainage after uniportal VATS pulmonary lobectomy can make patients have less postoperative chest pain,can effectively prevent lumen blockage.Moreover,it can accelerate the discharge of postoperative pleural effusion and gas accumulation,promote the early recovery of residual lung,and reduce hospitalization days after surgery.

关 键 词：双腔不等长胸腔闭式引流管并微负压吸引 胸腔引流管 电视胸腔镜 肺叶切除 

分 类 号：R655.3[医药卫生—外科学]