天津医药
天津醫藥
천진의약
TIANJIN MEDICAL JOURNAL
2015年
1期
85-87
,共3页
韩洪利%张逊%王冬滨%姚培宇
韓洪利%張遜%王鼕濱%姚培宇
한홍리%장손%왕동빈%요배우
胸腔镜检查%肺切除术%引流术%引流量%拔管
胸腔鏡檢查%肺切除術%引流術%引流量%拔管
흉강경검사%폐절제술%인류술%인류량%발관
thoracoscopy%pneumonectomy%drainage%drainage volume%removal of chest tubes
目的：观察电视辅助胸腔镜（VATS）肺叶切除术后不同胸腔引流量时拔除胸管对患者恢复的影响，以确定适合于尽早拔管的最佳引流量。方法将VATS肺叶切除术后行胸腔闭式引流的患者按纳入标准在术前随机分成3组，A组24 h引流量<100 mL，B组24 h引流量100～＜200 mL，C组24 h引流量200～300 mL。达到标准后立即拔除胸腔引流管。按出组标准排除后，最终得到符合研究设计的A组90例，B组87例，C组83例。记录各组间带管时间，肺感染、肺不张、拔管后气胸、拔管后胸腔积液、管口渗液、管口延迟愈合的病例数，以及镇痛药用量、术后住院天数等指标，进行统计学分析。结果 A、B、C组患者的平均带管时间（h）分别为91.76±15.59、84.17±18.33、56.14±12.25，应用吗啡缓释片平均剂量（mg）分别为236.82±67.20、187.36±76.64、139.29±52.74，术后住院天数（d）分别为11.47±1.90、10.68±2.50、10.23±2.14，C组以上各项数据均小于A组和B组，差异有统计学意义（P<0.05）；3组术后肺不张、术后肺感染、拔管后气胸、拔管后胸腔积液、管口渗液、管口延迟愈合的例数差异无统计学意义（P>0.05）。结论 VATS肺叶切除术后24 h引流量达到300 mL时拔除胸腔引流管是安全可靠的。
目的：觀察電視輔助胸腔鏡（VATS）肺葉切除術後不同胸腔引流量時拔除胸管對患者恢複的影響，以確定適閤于儘早拔管的最佳引流量。方法將VATS肺葉切除術後行胸腔閉式引流的患者按納入標準在術前隨機分成3組，A組24 h引流量<100 mL，B組24 h引流量100～＜200 mL，C組24 h引流量200～300 mL。達到標準後立即拔除胸腔引流管。按齣組標準排除後，最終得到符閤研究設計的A組90例，B組87例，C組83例。記錄各組間帶管時間，肺感染、肺不張、拔管後氣胸、拔管後胸腔積液、管口滲液、管口延遲愈閤的病例數，以及鎮痛藥用量、術後住院天數等指標，進行統計學分析。結果 A、B、C組患者的平均帶管時間（h）分彆為91.76±15.59、84.17±18.33、56.14±12.25，應用嗎啡緩釋片平均劑量（mg）分彆為236.82±67.20、187.36±76.64、139.29±52.74，術後住院天數（d）分彆為11.47±1.90、10.68±2.50、10.23±2.14，C組以上各項數據均小于A組和B組，差異有統計學意義（P<0.05）；3組術後肺不張、術後肺感染、拔管後氣胸、拔管後胸腔積液、管口滲液、管口延遲愈閤的例數差異無統計學意義（P>0.05）。結論 VATS肺葉切除術後24 h引流量達到300 mL時拔除胸腔引流管是安全可靠的。
목적：관찰전시보조흉강경（VATS）폐협절제술후불동흉강인류량시발제흉관대환자회복적영향，이학정괄합우진조발관적최가인류량。방법장VATS폐협절제술후행흉강폐식인류적환자안납입표준재술전수궤분성3조，A조24 h인류량<100 mL，B조24 h인류량100～＜200 mL，C조24 h인류량200～300 mL。체도표준후립즉발제흉강인류관。안출조표준배제후，최종득도부합연구설계적A조90례，B조87례，C조83례。기록각조간대관시간，폐감염、폐불장、발관후기흉、발관후흉강적액、관구삼액、관구연지유합적병례수，이급진통약용량、술후주원천수등지표，진행통계학분석。결과 A、B、C조환자적평균대관시간（h）분별위91.76±15.59、84.17±18.33、56.14±12.25，응용마배완석편평균제량（mg）분별위236.82±67.20、187.36±76.64、139.29±52.74，술후주원천수（d）분별위11.47±1.90、10.68±2.50、10.23±2.14，C조이상각항수거균소우A조화B조，차이유통계학의의（P<0.05）；3조술후폐불장、술후폐감염、발관후기흉、발관후흉강적액、관구삼액、관구연지유합적례수차이무통계학의의（P>0.05）。결론 VATS폐협절제술후24 h인류량체도300 mL시발제흉강인류관시안전가고적。
Objective To investigate the association between drainage volume and removal of chest tube after video-as?sisted thoracoscopic surgery(VATS) lobectomy. Methods Patients with VATS were randomly divided into three groups:the drainage volume was less than 100 mL/24 h (group A), the drainage volume was more than 100 mL/24 h but less than 200 mL/24 h(group B) and the drainage volume was more than 200 mL/24 h but less than 300 mL/24 h (group C). According to in?clusion criteria and exclusion criteria, finally there were 90 patients in group A, 87 patients in group B and 83 patients in group C. The duration of chest-tube drainage, the occurrence of pulmonary infection, pulmonary atelectasis, pneumothorax, hydrothorax, seepage or delayed union after removal of chest tube, the dosage of analgesic and the length of hospital stay af?ter surgery were recorded. Data were analyzed statistically. Results The average durations of chest-tube drainage were (91.76±15.59)h, (84.17±18.33)h and (56.14±12.25)h, the average morphine consumptions were (236.82±67.20)mg, (187.36± 76.64)mg and (139.29±52.74)mg, and the average lengths of hospital stay after surgery were (11.47±1.90)d, (10.68±2.50)d and (10.23 ± 2.14)d for three groups of patients, respectively. And the indexes in group C were distinctly lower than those in group A and group B (P<0.05). There were no significant differences in pulmonary atelectasis, the occurrence of postopera?tive pulmonary infection, pneumothorax, hydrothorax, seepage or delayed union after removal of chest tubes between three groups of patients (P > 0.05). Conclusion It is safe and acceptable that the removal of chest tube after VATS when the drainage volume reaches 300 mL within 24 h.
