8Fr腹腔引流管在胸腔镜肺部手术后快速康复的应用

Application of 8Fr abdominal drainage tube in rapid recovery after thoracoscopic lung surgery

目的比较胸腔镜肺部手术后放置8Fr+24Fr胸腔引流管与放置30 Fr胸腔引流管在术后快速康复的应用。方法选取本院2015年1月～2017年1月收治的113例胸腔镜肺部手术的患者,其中放置单根30 Fr胸腔引流管的23例,放置两根30Fr引流管的12例,分为第1组,为对照组;放置8Fr腹腔引流管+24Fr胸腔引流管的有78例,分为第2组,为试验组。首先对患者性别、年龄、TNM分期以及切除范围方面进行分析,并在术前与术后检测患者手术时间、出现胸膜粘连、24 h、48 h、72 h引流量、拔管前积气(10%～30%与0%～10%)、30 d胸腔有积液、带管时间、拔管前后VAS评分、手术前后住院时间。结果试验组与对照组患者在性别等基本信息方面比较差异并无统计学意义,术后引流指标中,试验组与对照组24 h、48 h、72 h引流量分别为(113.2±103.6)vs(256.7±192.1)、(226.2±172.8)vs(512.2±348.7)、(586±330.1)vs(813.8±438.6),相关并发症中,30 d胸腔积液指标比较差异并无统计学意义,而拔管前积气(10%～30%)、拔管前积气(0%～10%)分别为14vs18、21vs60,试验组均显著低于对照组。在临床效果中,两组患者在拔管前后VAS疼痛评分中并无差异,而试验组与对照组患者带管时间、术后住院时间分别为(53.1±24.8)vs(98.6±62.5)、(4.2±1.4)vs(6.5±3.0),试验组均显著小于对照组。结论在胸腔镜肺部手术中,8Fr腹腔引流管+24Fr胸腔引流管能够显著改善患者临床效果,并促进患者的术后康复。

Objective To compare the application of 8Fr＋24Fr abdominal drainage tube and 30Fr abdominal drainage tube in video-assisted thoracoscopic lung surgery. Methods Selecting 113 patients which admitted from January 2015 to January 2017, include 23 cases of single 30Fr abdominal drainage tube and 12 cases of double 30Fr abdominal drainage tube, which assigned to control group, and 78 cases of 8 Fr＋24 Fr abdominal drainage tube patients, which assigned to experiment group, first investigate the basic information about patients such gender, age, TNM stage and resection range, and detect the surgery time, pleural adhesionsappearaaace, induced discharge in 24 h, 48 h, 72 h, gas accumulation before extubation （10%-30% and 0%-10%）, Pleural effusion in 30d, intubation, VAS score before and after extubation and hospitalization time before and after operation. Results Basic information in control and experiment group such as gender has no difference, and in postoperative drainage index, experiment and control group drainage in 24 h, 48 h, 72 h was（113.2±103.6）vs（256.7±192.1）, （226.2±172.8）vs（512.2±348.7）, （586±330.1）vs（813.8±438.6）, in the complication.There was no significant difference in 30d pleural effusion index, but in gas accumulation before extubation（10%-30%）, and gas accumulation before extubation（0%-10%）, experiment and control group is 14vs18, 21vs60, experiment group is significantly lower than control group, in the clinical effect index, VAS index in 2 groups has no difference, but in intubation time and postoperative hospital stay time, experiment and control group is （53.1±24.8）vs（98.6±62.5）, （4.2± 1.4）vs（6.5±3.0）, experiment group is low than control group. Conclusion In video-assisted thoracoscopic lung surgery, 8Fr ＋ 24Fr abdominal drainage tube can significant improvement in patient outcomes, and promote the postoperative rehabilitation of the patients.