不同直径胸腔引流管是否加负压引流球对单操作孔胸腔镜下肺癌根治术后引流效果的影响分析

Analysis use different diameter thoracic drainage tube with negative pressure drainage ball on the chest drainage effect after biportal thoracoscopic radical resection for lung cancer

目的讨论单操作孔胸腔镜下肺癌根治术后选择不同直径胸管是否加负压引流球对胸腔引流效果的影响。方法收集2018年1月至2020年9月苏州大学附属第一医院胸外科行单操作孔胸腔镜下肺癌根治术300例患者,将其分为A和B两组,每组150例,A组术后放置1根28#胸腔引流管,B组术后放置1根20#胸腔引流管+1根沟槽负压引流球。结果分别比较A、B两组间患者手术后胸腔引流量、胸腔引流管留置时间、术后疼痛、术后需行胸腔穿刺发生率、住院时间及总住院费用。A、B两组患者在性别、年龄、术后病理类型、手术切除范围等一般资料方面比较差异无统计学意义(P>0.05);术后胸腔引流总量[(1010.31±525.29)ml对(985.35±403.93)ml]和胸腔引流管总留置时间[(5.69±2.55)天对(5.42±1.94)天]两组之间差异无统计学意义(P>0.05);不同直径胸腔引流管留置时间[(5.69±2.55)天对(2.88±0.64)天]差异有统计学意义(P<0.05);住院[(12.64±2.89)天对(11.25±1.62)天]与总住院费用[(64327.00±3587.04)元对(62899.00±1588.82)元]差异有统计学意义(P<0.05);术后疼痛VAS评分方面,术后1天(3.66±0.51对3.57±0.49)、术后2天(4.09±0.48对4.17±0.53)、术后3天(5.62±0.87对5.85±1.06)差异无统计学意义(P>0.05),术后5天(4.47±1.01对3.51±0.49)差异有统计学意义(P<0.05);术后需行胸腔穿刺发生率A组为10%,B组为0,差异有统计学意义(P<0.05)。结论单操作孔胸腔镜下肺癌根治术后使用细管引流,并加用1根负压引流球,不会导致患者术后疼痛加重,负压引流球可带管出院,从而节省患者住院时间,并可显著控制术后患者行胸腔穿刺发生率,进而降低患者所需术后总费用。

Objective To explore the chest drainage effect of use different diameter thoracic drainage tube after biportal thoracoscopic radical resection for lung cancer.Methods 300 patients with lung cancer who received biportal thoracoscopic radical resection were divided into group A and group B from January 2018 to September 2020.Group A:150 patients with single 28#thoracic drainage tube after surgery.Group B:150 patients with single 20#thoracic drainage tube and a negative pressure drainage ball after surgery.The postoperative drainage volume,drainage time,postoperative pain,postoperative thoracic puncture,hospital stay and total hospital expenses were compared.Results No significant difference between the two groups in terms of sex,age,postoperative pathological type and resection range.There no significant difference between the two groups in total drainage volume[(1010.31±525.29)ml vs.(985.35±403.93)ml]and total drainage time[(5.69±2.55)days vs.(5.42±1.94)days].The difference of different diameter thoracic drainage tube used[(5.69±2.55)days vs.(2.88±0.64)days]was statistically significant.There were significant differences between two groups in terms of hospital stay[(12.64±2.89)days vs.(11.25±1.62)days]and total hospital expenses[(62899.00±1588.82)yuan vs.(64327.00±3587.04)yuan].No significant differences on the postoperative first day,second day and third day in VAS pain scores.However,on the postoperative fifth day,the difference was statistically significant.In addition,the rate of group A postoperative thoracic puncture was 10%,group B was 0,the comparison was statistically significant.Conclusion Using a single thin thoracic drainage tube and plus a negative pressure drainage ball after biportal thoracoscopic radical resection for lung cancer will not cause pain increase,shorten hospital stay days,control the rate of postoperative thoracic puncture and then reduce patients total hospital expenses.