原发性自发性气胸术后单管引流与双管引流对比研究

A Comparative Study of Single Chest Tube Drainage Versus Dual Tube Drainage Post Thoracic Surgery in Primary Spontaneous Pneumothorax

目的:对比单管引流与双管引流在原发性自发性气胸术后的治疗效果。方法:将260例原发性自发性气胸患者分为单管引流组与双管引流组,均行胸腔镜手术,单管引流组为在腋中线第6肋间安置胸腔闭式引流管至胸顶,双管引流组为在腋中线第6肋间及锁骨中线第2肋间各安置胸腔闭式引流管,比较两组的疗效。结果:两组术后漏气时间、术后7 d疼痛评分、肺不张、需再次置管方面比较,差异均无统计学意义(P>0.05)。两组术后1、3 d疼痛评分比较,差异均有统计学意义(P<0.05)。结论:原发性自发性气胸胸腔镜术后单管引流可取代传统的双管引流达到治疗效果,同时具有疼痛较轻的特点,临床操作更简单、更能改善患者舒适度,利于患者术后排痰和活动,值得临床推广。

Objective： To compare the curative effect of single chest tube drainage with dual tube drainage after video-assisted thoracic surgery（VATS） in primary spontaneous pneumothorax.Method： 260 patients with primary spontaneous pneumothorax all received VATS and were subsequently divided into single tube group and dual tube group according to the style of chest tube drainage.In the single tube group, the chest tube was inserted at the sixth intercostal space at the midaxillary line, and directed towards the apex.The second chest tube was inserted at the second intercostal space at the midclavicular line in the dual tube group.The effects of two groups were compared.Result： There were no significant statistical differences in postoperative leakage time, the 7th day postoperative pain score, atelectasis and in need of retubing between two groups（P〉0.05）,However, the postoperative pain score on the 1st day and the 3rd day were significantly different between two groups（P〈0.05）.Conclusion： Although statistical power is insufficient to formally confirm therapeutic equality, this study suggests that treatment with single chest tube drainage for primary spontaneous pneumothorax seems equally effective as dual tube drainage, but results in less pain, is safer, well tolerated and easier on postoperative expectoration and activities.