肺癌术后胸腔闭式引流术应用的新观念

The Current Concepts of Closed Chest Drainage in Lobectomy of Lung Cancer

肺叶切除术后应用传统胸腔闭式引流术,被大多数胸外科医生所采用的主要原因:一是引流效果好;二是经验、习惯和观念。外科技术的发展和医疗观念的更新使传统胸腔闭式引流术在临床应用中的不足越来越明显,但尚未引起足够重视。近几年对肺癌术后引流问题无论是应用方法还是观念都有更新和发展。本文将结合国内外研究进展和我们工作中的体会,从以下三方面进行概述:一是胸腔引流术应用现状和存在问题;二是常规水封引流系统加用负压吸引之优势与不足;三是单胸腔引流管的临床应用进展与争议。

It is widely accepted by most thoracic surgeons that a complete control on fluid and air in the pleural space could only be maintained by conventional closed chest drainage （two chest tubes）.With the development of medical models and devices in pneumonectomy,the validity of this concept is being questioned.In this review,we summarized that： the current situation and problems of closed chest drainage;the advantage and disadvantage of water seal with or without suction on chest drainage;and the advances and contradiction of single chest tube drainage after pneumonectomy.