带金属支撑多侧孔与普通超细引流管应用于单孔胸腔镜肺下叶切除术的回顾性队列研究

The clinical application of metal supported multi-sided versus ordinary ultra-fine drainage tube in the uniportal video-assisted thoracoscopic lower pulmonary lobectomy:A retrospective cohort study

目的比较带金属支撑的多侧孔超细引流管与普通超细引流管在单孔胸腔镜肺下叶切除术中的临床应用效果。方法回顾性分析2021年1月—2022年6月兰州大学第一医院胸外科收治的行单孔胸腔镜肺下叶切除术肺癌根治患者的临床资料。根据术中使用超细引流管类型的不同,将患者分为试验组(使用带金属支撑的多侧孔10F超细引流管)与对照组(使用普通12F超细引流管)。比较两组患者的临床资料。结果共纳入190例患者,其中男108例、女82例。试验组90例,平均年龄(56.60±10.14)岁;对照组100例,平均年龄(57.07±11.04)岁。试验组术后肺部感染、胸腔积液发生率低于对照组,差异有统计学意义(P<0.05);两组患者术后疼痛视觉模拟评分、术后需调整胸腔引流管、术后需再次行胸腔穿刺置管、术后胸腔引流管拔除时间、住院费用差异有统计学意义(P<0.05);两组患者术前麻醉时间、手术时间、术中出血量、清扫淋巴结站数、术后住院时间以及术后肺漏气、心律失常、肺不张并发症发生率差异无统计学意义(P>0.05)。结论带金属支撑的多侧孔超细引流管相比普通超细引流管可降低单孔胸腔镜肺下叶切除术后肺部感染、胸腔积液并发症发生率,减轻疼痛、经济负担,可在单孔胸腔镜肺下叶切除术中推广应用。

Objective To investigate the clinical effect of metal supported multi-sided versus ordinary ultra-fine drainage tube in the uniportal video-assisted thoracic surgery(VATS) lower pulmonary lobectomy.Methods From January 2021 to June 2022,the clinical data of patients who underwent uniportal VATS lower lobectomy in our hospital were retrospectively analyzed.According to the different types of ultra-fine drainage tubes used in the surgery,the patients were divided into an experimental group(using multi-sided hole 10F ultra-fine drainage tubes with metal support) and a control group(using ordinary 12F ultra-fine drainage tubes).The clinical data of the two groups were compared.Results A total of 190 patients were enrolled,including 108 males and 82 females.There were 90 patients in the experimental group aged 56.60±10.14 years;and 100 patients in the control group aged 57.07±11.04 years.The incidences of postoperative lung infection and pleural effusion in the experimental group were lower than those in the control group,with statistically significant differences(P<0.05).The postoperative visual analogue scale score,the need to adjust the chest drainage tube after the surgery,the need for chest puncture after the surgery,the time of postoperative chest tube removal,and the hospitalization cost were statistically different(P<0.05).There was no statistical difference in the length of postoperative hospital stay or the incidences of postoperative lung leakage,arrhythmia,and atelectasis complications(P>0.05).Conclusion Compared with the ordinary ultra-fine drainage tubes,multi-sided hole ultra-fine drainage tubes with metal support can reduce the incidences of lung infection and pleural effusion complications after the uniportal VATS lower lobectomy,reduce the pain and economic burden,which can be applied in the uniportal VATS lower lobectomy.