胸腔镜下叶肺癌手术引流管留置不同深度临床效果对比  

The effect of different depth of thoracic drainage tube in lower lobectomy by video-assisted thoracic

作　　者：杨根荣 王晗 赵明理[1] Yang Genrong;Wang Han;Zhao Mingli

机构地区：[1]河南中医药大学第一附属医院胸外科,郑州450000

出　　处：《实用医技杂志》2024年第7期466-468,共3页Journal of Practical Medical Techniques

基　　金：河南省中医药科学研究专项课题(20-21ZY2028)。

摘　　要：目的分析胸腔镜下叶肺癌手术胸腔引流管留置不同深度的临床效果。方法选择2022年6月至2023年12月我科收治的下叶肺癌患者90例,行单操作孔胸腔镜肺下叶切除+淋巴结清扫,术后经观察孔留置单一28号硅胶引流管,按照住院号随机分为观察组、对照组各45例,观察组胸腔引流管留置深度5~6 cm,对照组10~14 cm,对2组试验对象的引流量、引流时间、住院时间、肺不张、胸腔积液发生率、术后第1~3天疼痛评分等进行统计比较。结果观察组与对照组的引流量[(707±137)ml与(764±159)ml,t=-1.793,P=0.076]、引流时间[(4.0±0.8)与(4.2±0.8),t=-1.619,P=0.109]、术后住院时间[(8.8±1.1)与(9.0±1.3),t=-0.704,P=0.483]比较差异均无统计学意义(P>0.05);观察者与对照组术后肺不张发生率[3/45与5/45,χ^(2)=0.549,P=0.357]、胸腔积液发生率(6/45与4/45,χ^(2)=0.450,P=0.370),差异均无统计学意义(P>0.05);观察组与对照组术后胸痛评分比较,第1天[(6.6±1.1)分与(7.9±1.1)分,t=-5.648,P<0.001],第2天[(5.2±0.8)分与(6.2±0.7)分,t=-5.606,P<0.001],第3天[(3.9±0.9)分与(4.7±0.7)分,t=-4.428,P<0.001],差异均有统计学意义(P<0.05)。结论对于下叶肺癌行单操作孔胸腔镜肺下叶切除病例,经观察孔放置深度较短的引流管可以降低术后胸痛程度,且引流效果不会受到影响。Objective To analyze the effect of the thoracic drainage tube with different depth after lower lobectomy by video-assisted thoracic.Methods Ninty patients with lower lobe lung cancer in our department from June 2022 to December 2023 were selected as subjects and were performed single operator-hole thoracoscopic lower lobectomy plus lymph node dissection.A single 28 silicone drainage tube was indwelled through the observation hole.The patients were divided into two groups randomly according hospitalization information,45 cases in each group.The depth of thoracic drainage tube in the observation group was 5~6 cm,and 10~14 cm in the control group.The volume of drainage,drainage time,hospital stay,incidence of atelectasis and pleural effusion,pain score in the first three days were compared between the two groups.Results There were no significant differences in the volume of drainage[(707±137)ml vs(764±159)ml,t=-1.793,P=0.076],drainage time[(4.0±0.8)d vs(4.2±0.8),t=-1.619,P=0.109],hospital stay[(8.8±1.1)d vs(9.0±1.3)d,t=-0.704,P=0.483],incidence of atelectasis(3/45 vs 5/45,χ^(2)=0.549,P=0.357)and pleural effusion(6/45 vs 4/45,χ^(2)=0.450,P=0.370)between the two groups(P>0.05).The VAS scores of the observation group were significantly lower than those of the control group in the first three days after surgery,[day1:(6.6±1.1)vs(7.9±1.1),t=-5.648,P<0.001;day2:(5.2±0.8)vs(6.2±0.7),t=-5.606,P<0.001;day3:(3.9±0.9)vs(4.7±0.7),t=-4.428,P<0.001].Conclusion Shorter drainage tube placement through the observation hole can reduce the degree of chest pain after the single operator-hole thoracoscopic lobectomy for lower lobe lung cancer and the effect will not be affected.

关 键 词：电视辅助胸腔腔镜手术 肺下叶切除术 胸腔引流 

分 类 号：R734.2[医药卫生—肿瘤]