数字化胸腔引流系统用于肺部手术后难治性持续性漏气的疗效观察

发布时间：2018-02-09 15:17

本文关键词： 数字化胸腔引流系统难治性持续性漏气肺切除外科　出处：《中国肺癌杂志》2017年12期 　论文类型：期刊论文

【摘要】：背景与目的术后持续性肺漏气是肺部手术后最常见的并发症之一。数字化胸腔引流系统(digital drainage system,DDS)被认为具有准确、客观、舒适、患者耐受性好、经济等优点。本研究旨在总结DDS用于肺部手术后难治性持续性大量漏气的临床疗效。方法术后5天和7天分别是胸腔镜和开胸术后持续性肺漏气(prolonged air leak,PAL)的界限;本研究将难治性持续性大量漏气定义为达到PAL时间2倍及以上且漏气持续达2度以上,可伴有明显皮下气肿或纵隔气肿等相关并发症。2016年1月-2016年12月间,应用数字化胸腔引流系统结合胸膜固定术治疗符合上述标准的病例共8例,收集相关临床资料并总结分析。结果本组病例中肺叶切除术6例,肺段切除2例。平均术后持续漏气(17.3±5.1)d,DDS平均使用时间(5.6±3.7)d。平均术后引流量(3,550.6±1,881.1)mL。应用DDS前后的平均引流量为(2,615.6±1,741.2)mL和(935.0±242.7)mL。平均住院时间(18.1±5.0)d。结论数字化胸腔引流系统用于肺部手术后难治性持续性大量漏气安全可行,可提供更大的负压吸引值,从而促使患肺复张为后继的胸膜固定术创造条件,并缩短引流天数和住院时间。
[Abstract]:Background & objective persistent pulmonary leakage is one of the most common complications after pulmonary surgery. Digital thoracic drainage system digital drainage system is considered to be accurate, objective, comfortable and patient with good tolerance. The purpose of this study was to summarize the clinical efficacy of DDS in the treatment of persistent persistent massive air leakage after pulmonary surgery. Methods 5 and 7 days after operation were the boundaries of persistent air leak after thoracoscopy and thoracotomy, respectively. In this study, refractory persistent massive air leakage was defined as two or more times of PAL time and more than 2 degrees of air leakage, which could be accompanied by obvious subcutaneous emphysema or mediastinal emphysema and other related complications. Between January 2016 and December 2016, there were some complications, such as severe subcutaneous emphysema and mediastinal emphysema. Digital pleural drainage system combined with pleural fixation was used to treat 8 patients who met the above criteria. The clinical data were collected and analyzed. There were 2 cases of pulmonary segmental resection. The average time of continuous air leakage was 17.3 卤5.1 d after operation. The mean time of DDS was 5.6 卤3.7 d. The average postoperative drainage volume was 3550.6 卤1 881.1 mL. The average drainage volume before and after DDS was 215.6 卤1,741.2mL and 935.0 卤242.7mL.The average hospitalization time was 18.1 卤5.0mL.Conclusion Digital thoracic drainage system can be used in lung surgery. A large amount of air leakage after refractory persistence is safe and feasible. It can provide a greater suction value of negative pressure, thus enabling pulmonary retraction to create conditions for subsequent pleural fixation, and to shorten drainage days and hospital stay.
【作者单位】：同济大学附属上海市肺科医院;
【分类号】：R655.3

【相似文献】