猪源纤维蛋白粘合剂对减少胸腔镜肺癌根治术后胸腔引流量的效果

Effect analysis of porcine fibrin sealant on reducing pleural drainage volume after thoracoscopic radical resection of lung cancer

目的通过研究猪源纤维蛋白粘合剂对减少胸腔镜肺癌根治术后患者胸腔引流量的疗效性,为其在胸外科临床中的应用提供经验。方法回顾性分析2017年1月—2021年5月本科268例胸腔镜肺癌根治手术(肺叶切除及淋巴结清扫术)患者的临床资料。根据胸腔内手术创面有无喷洒猪源纤维蛋白粘合剂将其分为对照组(n=118,未喷洒猪源纤维蛋白粘合剂)和试验组(n=150,喷洒猪源纤维蛋白粘合剂),比较两组患者一般资料及术后胸腔引流量、胸腔引流管带管时间及术后住院时间指标。结果本研究共纳入268例患者,其中对照组男性49例,女性69例;年龄37~76岁,平均(59.12±0.76)岁;试验组男性77例,女性73例;年龄35~76岁,平均(58.78±0.59)岁。两组患者一般资料比较无显著性差异(均P>0.05);两组观察指标胸腔引流量(599.21±27.67 mL vs.461.68±23.99 mL,P=0.000),胸腔引流管带管时间(3.45±0.07 d vs.3.25±0.05 d,P=0.021),术后住院时间(4.45±0.07 d vs.4.26±0.05 d,P=0.026),差异有统计学意义(均P<0.05)。术后均未出现过敏、胸腔感染病例。结论胸腔镜肺癌根治术后胸腔内手术创面喷洒猪源纤维蛋白粘合剂可减少胸腔引流量,缩短胸腔引流管带管时间,缩短患者术后住院时间,且安全、可靠,可在胸外科临床推广应用。

Objective To investigate the effect of porcine fibrin sealant on reducing pleural drainage volume after thoracoscopic radical resection of lung cancer in order to provide clinical experience in the application of thoracic surgery.Methods The clinical data of 268 lung cancer patients undergoing thoracoscopic radical resection of lung cancer(pulmonary with lymph node resection) in our hospital from January 2017 to May 2021 were collected. According to the intrathoracic surgical wound whether to spray porcine fibrin sealant, they were divided into the control group(n=118, no spraying porcine fibrin sealant) and the experimental group(n=150, spraying porcine fibrin sealant). The general information, the postoperative pleural drainage volume, the duration of chest tube drainage and the postoperative length of stay were compared.Results Two hundred and sixty-eight patients participated in this study, with 49 males and 69 females in the control group aged 37~76 years old with the median age 59.12±0.76 years old;there were 77 males and 73 females in the experimental group aged 35~76 years old with the median age 58.78±0.59 years old. There was no significant difference in general information between the two groups(average P>0.05). Significant differences were observed between the two groups with respect to the postoperative pleural drainage volume(599.21±27.67 mL vs. 461.68±23.99 mL, P=0.000), the duration of chest tube drainage(3.45±0.07 d vs. 3.25±0.05 d, P=0.021), and the postoperative length of stay(4.45±0.07 d vs. 4.26±0.05 d, P=0.026), and these differences were statistically significant(average P<0.05). There was no case of allergic reaction and intrathoracic infection after the operation. Conclusion Spraying porcine fibrin sealant on the wound of intrathoracic surgery after thoracoscopic radical resection of lung cancer can reduce pleural drainage volume, and shorten the duration of chest tube drainage and postoperative length of stay. It is safe and reliable, and can be widely used in thoracic surgery.