胸腔镜肺减容术后两种胸腔闭式引流方式安全性与可行性分析

Analysis of the safety and feasibility of two closed thoracic drainage methods after video-assisted thoracoscopic lung volume reduction surgery

目的探讨胸腔镜肺减容术后单管与双管两种胸腔闭式引流的效果。方法回顾性分析2013年1月至2019年3月于我院行三孔胸腔镜肺减容术的50例患者的临床资料,男39例、女11例,其中25例术后留置单管者为观察组,平均年龄(58.72±7.96)岁,25例术后留置双管者为对照组,平均年龄(58.92±8.07)岁。结果两组患者术后均痊愈出院,围手术期无死亡病例。两组患者在术后第3 d肺复张情况、术后并发症发生率、拔管前胸腔引流管通畅率、留管时间、术后住院时间方面差异无统计学意义(P>0.05)。观察组术后疼痛程度低于对照组(P<0.05),观察组拔管前非甾体类止痛药应用总量少于对照组(P<0.05)。结论胸腔镜肺减容术后留置单管行胸腔闭式引流安全有效,患者术后疼痛程度明显减轻,止痛药物的使用明显减少,可降低相关药物不良反应的发生率,利于术后快速康复。

Objective To investigate the effects of closed thoracic drainage with single tube or double tubes after video-assisted thoracoscopic lung volume reduction surgery.Methods Retrospective analysis was performed on 50 patients(39 males,11 females)who underwent three-port thoracoscopic lung volume reduction surgery in our hospital from January 2013 to March 2019.Twenty-five patients with single indwelling tube after surgery were divided into the observation group and 25 patients with double indwelling tubes were divided into the control group.Results There was no significant difference in pulmonary retension on day 3 after surgery,postoperative complications,the patency rate of drainage tube before extubation,retention time or postoperative hospital stay(P>0.05).Postoperative pain and total amount of nonsteroidal analgesics use in the observation group was less than those in the control group(P<0.05).Conclusion It is safe and effective to perform closed thoracic drainage with single indwelling tube after video-assisted thoracoscopic lung volume reduction surgery,which can significantly reduce the incidence of related adverse drug reactions and facilitate rapid postoperative rehabilitation with a reduction of postoperative pain and the use of analgesic drugs.