术后细管辅助粗管胸腔闭式引流置管方式对VATS肺叶切除患者的疗效

Effect of thick tube thoracic close drainage assisted by thin tube after VATS lobectomy

目的探讨电视胸腔镜手术(VATS)肺叶切除术后细管辅助粗管胸腔闭式引流置管方式的疗效。方法选择2009年8月~2016年8月在我院行VATS肺叶切除术后的78例非小细胞肺癌患者,根据胸腔闭式引流方法的不同分为观察组40例(采用细管辅助粗管胸腔闭式引流)和对照组38例(采用常规改良胸腔闭式引流),比较两组围术期情况(手术时间、出血量、清扫淋巴数量、下床时间、住院时间、留管时间、引流量、引流效果、VAS疼痛评分)、术后并发症及患者满意率。结果两组手术时间、出血量、清扫淋巴数量、留管时间和总引流量等比较,差异无统计学意义(P>0.05),而观察组的下床时间和住院时间均短于对照组,差异有统计学意义(P<0.05)。引流效果良好率和患者满意率均显著高于对照组(P<0.05),并发症发生率和VAS疼痛评分低于对照组(P<0.05)。结论VATS肺叶切除术后细管辅助粗管胸腔闭式引流的疗效更确切,恢复更快,疼痛等负性体验和并发症更少,不增加手术时间、难度和风险,患者满意度高,值得临床推广。

Objective To explore the effect of thick tube thoracic close drainage assisted by thin tube after video-assist- ed thoracic surgery （VATS） lobeetomy.Methods From August 2009 to August 2016,78 patients with non-small cell lung cancer after VATS lobectomy in our hospital were divided into observation group （n=40,adopting thick tube thoracic close drainage assisted by thin tube） and control group （n=38,adopting conventional improved thoracic close drainage） accord- ing to the different methods of closed thoracic drainage.Perioperative condition （operation time,blood loss,number of cleaning lymph node,time of getting out of bed,length of hospitalization,time of remaining the catheter,volume of drainage,drainage effect,VAS pain seore）,complications rate and patients＇ satisfaction were compared between two groups.Results Operation time,blood loss,number of cleaning lymph node,time of remaining the catheter and total vol- ume of drainage between two groups had no statistical differences（P〉0.05）.Time of getting out of bed and length of hos- pitalization in the observation group was shorter than that in the control group （P〈0.05）.Drainage effect and patients＇ satisfaction was significantly higher than that in the control group （P〈0.05）,the complication rate and VAS pain score was significantly lower than that in the control group （P〈0.05）.Conclusion The thoracic close drainage assisted by thin tube has more accurate curative effect,faster recovery,less pain and complications,higher patients＇ satisfaction,which is worth to be promoted.