胸腔镜肺癌根治术后不使用止血药物的安全性

Safety of not using hemostatic drugs after thoracoscopic radical surgery for lung cancer

目的探讨肺癌患者电视辅助胸腔镜手术(VATS)后不使用止血药物的安全性。方法100例行VATS肺癌患者分为研究组(术后不使用任何止血药物,n=55)及对照组(术后常规使用止血药物,n=45),收集2组患者年龄、性别、病变部位等一般资料,记录患者手术前后凝血酶原时间、部分活化凝血活酶时间、凝血酶时间、血红蛋白量、血小板计数及红细胞计数,比较2组患者手术持续时间及出血量、术后3 d内的胸腔引流量、带管时间、住院时间、并发症及不良反应。结果2组患者术前和术中临床资料比较,差异无统计学意义(P>0.05);2组患者术后第1、2及3天引流量、带管时间及住院时间比较,差异无统计学意义(P>0.05);2组患者手术前后凝血功能及血细胞计数各指标比较,差异无统计学意义(P>0.05);2组患者均未出现严重的围手术期并发症及需要二次手术的情况,且对照组患者术后3 d内消化道反应(恶心、呕吐)及头痛发生率高于研究组(P<0.05)。结论与使用止血药物相比,肺癌患者VATS术后不使用止血药物不会增加术后出血风险,具有一定的安全性。

Objective To explore the safety of not using hemostatic drugs after video-assisted thoracoscopic surgery(VATS)for patients with lung cancer.Methods A total of 100 patients with lung cancer for VATS were divided into a study group(without any postoperative hemostatic drugs,n=55)and control group(with routine postoperative hemostatic drugs,n=45).General data was collected from two groups of the patients,including age,gender,lesion sites,etc..The patients'coagulation indexes,prothrombin time,partial activated thromboplastin time,thrombin time,preoperative blood cell count,hemoglobin amount,platelet count and red blood cell count were documented before and after surgery.The duration of surgery,bleeding volume,chest drainage volume within 3 days after surgery,tube duration,length of hospital stay,complications,and adverse reactions were compared between two groups.Results There was no statistically significant difference in clinical data before and after surgery between two groups of patients(P>0.05).There were no statistically significant differences in drainage volume,catheterization time,and hospitalization time between two groups of patients on the 1 st,2 nd,and 3 rd days after surgery(P>0.05).There were no statistically significant differences in coagulation function and blood cell count between two groups of the patients before and after surgery(P>0.05).Both groups of the patients did not have severe perioperative complications or the need for the second surgery.Control group had a higher incidence of gastrointestinal reactions(nausea,vomiting)and headaches within 3 days after surgery when compared to study group(P<0.05).Conclusion When compared with the use of hemostatic drugs,not using hemostatic drugs after VATS for the patients with lung cancer does not increase the risk of postoperative bleeding and exhibit a certain degree of safety.