胸腔镜肺大疱切除术后不放置胸腔引流管30例应用效果  

Application effects of thoracoscopic resection of a pulmonary bulla without tube thoracostomy

作　　者：李春 Chun Li(Department of Thoracic Surgery,Urumqi Youai Hospital,Urumqi 830000,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]乌鲁木齐友爱医院胸外科,乌鲁木齐830000

出　　处：《中国基层医药》2023年第1期72-75,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：乌鲁木齐友爱医院科技计划(202007)

摘　　要：目的:探讨胸腔镜肺大疱切除术后不放置胸腔引流管的应用效果。方法:选取乌鲁木齐友爱医院2019年1月至2021年1月行胸腔镜肺大疱切除的患者60例,采用随机数字表法分为观察组、对照组各30例,观察组术后不放置胸腔引流管,对照组放置胸腔引流管。比较两组患者术后24 h氧合指数、术后24 h、48 h、72 h疼痛评分、术后并发症、术后住院天数、总住院费用等指标。结果:两组术后24 h氧合指数差异无统计学意义( P > 0.05)。观察组术后24、48、72 h疼痛评分分别为(2.6±1.2)分、(1.5±0.8)分、(0.9±1.1)分,均低于对照组的(4.5±1.4)分、(3.8±1.5)分、(2.8±1.7)分( t=1.34、1.13、0.92,均 P < 0.05)。观察组术后胸腔积液发生率、并发症总发生率分别为3.33%(1/30)、20.00%(6/30),均低于对照组的26.67%(8/30)、46.67%(14/30)(χ^(2)=6.40、4.25,均 P < 0.05)。观察组术后住院时间、住院费用分别为(3.4±0.8)d、(1.1±0.3)万元,均明显短于、少于对照组的(6.5±1.4)d、(1.4±0.5)万元,差异均有统计学意义( t=10.22、-1.88,均 P < 0.05)。 结论:胸腔镜肺大疱切除术后不放置胸腔引流管是可行的、安全的,有一定的推广价值。Objective To investigate the application effects of thoracoscopic resection of a pulmonary bulla without tube thoracostomy.Methods A total of 60 patients who underwent thoracoscopic resection of a pulmonary bulla from January 2019 to January 2021 in Urumqi Youai Hospital were included in this study.They were randomly divided into an observation group and a control group(n=30/group).Tube thoracostomy was performed in the control group but not in the observation group.Oxygenation index measured at 24 hours,pain score measured at 24,48 and 72 hours after surgery,complications,hospital stay,and total hospitalization expense were compared between the two groups.Results There was no significant significance in oxygenation index measured at 24 hours between the two groups(P>0.05).At 24,48 and 72 hours after surgery,pain score in the observation group was(2.6±1.2)points,(1.5±0.8)points,and(0.9±1.1)points,respectively,which were significantly lower than(4.5±1.4)points,(3.8±1.5)points,(2.8±1.7)points in the control group(t=1.34,1.13,0.92,all P<0.05).The total incidences of postoperative pleural effusion and complications in the observation group were 3.3%(1/30)and 20.0%(6/30),respectively,which were significantly lower than 26.7%(8/30)and 46.7%(14/30)in the control group(χ^(2)=6.40,4.25,both P<0.05).The postoperative hospitalization time and total hospitalization expense in the observation group were(3.4±0.8)days and(1.1±0.3)×10000 yuan,respectively,which were significantly shorter or less than(6.5±1.4)days and(1.4±0.5)×10000 yuan in the control group(t=10.22,-1.88,both P<0.05).Conclusion Thoracoscopic resection of a pulmonary bulla without tube thoracostomy is feasible and safe,which has a certain promotion value.

关 键 词：胸腔镜检查 最小侵入性外科手术 肺大疱切除术 胸管 胸腔引流 氧合指数 疼痛测定 手术后并发症 病例对照研究 

分 类 号：R655.3[医药卫生—外科学]