胸腔镜肺叶切除术后16F尿管胸腔引流可行性的前瞻性队列研究

发布时间：2018-02-09 17:35

本文关键词： F尿管胸腔镜肺叶切除术快速康复　出处：《中国胸心血管外科临床杂志》2016年04期 　论文类型：期刊论文

【摘要】：目的探讨胸腔镜肺叶切除术(video-assisted thoracic surgery,VATS)后应用16 F尿管行胸腔引流是否增加了术后并发症及其较28 F引流管的临床优势。方法 2015年10~12月四川大学华西医院胸外科连续收治102例肺癌行VATS肺叶切除术患者,分别应用16 F尿管(16 F组,49例)和28 F引流管(28 F组,53例)行胸腔引流,分析术后胸腔积气、积液、30 d后胸腔积液,术后住院时间、引流量、引流持续时间、术后引流管拆线时间、视觉疼痛评分(VAS)评分和舒适度及引流口愈合情况。结果 16 F组胸腔引流总量少于28 F组,差异有统计学意义[(587.3±323.7)ml vs.(824.1±444.3)ml,P=0.000)]。两组患者术后肺部并发症发生率(16 F组,30.6%;28 F组,28.3%)差异无统计学意义(P=0.102)。16 F组皮下气肿发生率(60.0%)显著高于28 F组(6.7%,P=0.011),16 F组再置管率(2.0%)低于28 F组(5.7%,P=0.048)。16 F组引流时间和术后住院时间[(54.2±28.6)h,(4.2±1.4)d)]均显著短于28 F组[(95.6±65.5)h,(6.5±3.0)d,P=0.000,P=0.000)]。16 F组引流管口拆线时间显著短于28 F组[(8.1±1.2)d vs.(14.3±4.1)d,P=0.033]。而16 F组引流管口Ⅰ级愈合率(100.0%)显著高于28 F组(58.5%,P=0.014)。结论胸腔镜肺叶切除术后用16 F尿管行胸腔引流可行,且有助于患者快速康复。
[Abstract]:Objective to investigate whether thoracic drainage with 16F catheter after thoracoscopic lobectomy with video-assisted thoracic surgeryus (VATS) increases postoperative complications and its clinical advantages over 28 F drainage tube. Methods from 2015 to December, thoracic surgery of West China Hospital of Sichuan University was performed. 102 patients with lung cancer underwent VATS lobectomy, Thoracic drainage was performed in 49 cases of 16F urinary catheter group (16F) and 53 cases of 28F drainage tube (group 28F). The postoperative air accumulation, hydrothorax, postoperative hospitalization time, drainage time and drainage duration were analyzed. Results the total amount of thoracic drainage in 16F group was less than that in 28F group. There was no significant difference in the incidence of postoperative pulmonary complications between the two groups (587.3 卤323.7ml vs.(824.1 卤444.3ml vs.(824.1 卤444.3ml Pu 0.000). There was no significant difference in the incidence of postoperative pulmonary complications between the two groups. There was no significant difference in the incidence of emphysema between the two groups (P < 0.102, P < 0.05). The incidence of emphysema in group F was significantly higher than that in group 28F, which was significantly higher than that in group C (6.74.3ml). The recanalization rate in group F was lower than that in group 28F (2.0). The drainage time and postoperative hospital stay in group F were significantly shorter than those in group 28 F [54.2 卤28.6hU 4.2 卤1.4 days]. 16F group was significantly shorter than that of 28F group [95.6 卤65.5dP0. 000 P0. 000] .16F group was significantly shorter than 28F group [8.1 卤1. 2d vs.(14.3 卤4.1 d P0. 033], while 16F group was significantly higher than 28 F group (58.5P0. 014). Conclusion thoracoscopy is significantly higher than that of 28 F group (P 0. 014). Thoracic drainage with 16F catheter after lobectomy was feasible. And it is helpful for the patients to recover quickly.
【作者单位】：四川大学华西医院胸外科;四川大学华西医院呼吸内科;
【基金】：四川省科技厅基金资助(2014 SZ 0148;2015 SZ 0158) 四川大学华西医院学科卓越发展1.3.5工程项目资助~~
【分类号】：R473.73

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