CAJ | 학술논문

目的：探讨肺叶切除术后胸腔引流改进方法在术后快速康复中的作用。方法将本院166例肺叶切除术患者随机分为两组，88例术后采用单胸腔引流管引流，胸腔引流量≤300 ml/24h时拔除引流管（改进组），78例术后采用常规方法引流，胸腔引流量≤100 ml/24h时拔除引流管（常规组）。记录两组患者术后胸腔引流量、引流管留置时间、术后住院时间、术后及拔管后胸部并发症发生情况。结果改进组患者术后视觉模拟评分法（VAS）评分低于常规组（P＜0.01），术后24小时胸腔引流量略低于常规组（P＞0.05），胸腔引流管留置时间及住院时间均明显短于常规组（P＜0.05）。两组患者术后及拔管后胸部并发症发生率比较差异均无显著性（P＞0.05）。结论肺叶切除术后单管胸腔引流是有效的，将拔除胸腔引流管的指征设定为引流量≤300 ml/24h是可行的，并不增加术后胸部并发症发生率，有利于患者术后的快速康复。
목적：탐토폐협절제술후흉강인류개진방법재술후쾌속강복중적작용。방법장본원166례폐협절제술환자수궤분위량조，88례술후채용단흉강인류관인류，흉강인류량≤300 ml/24h시발제인류관（개진조），78례술후채용상규방법인류，흉강인류량≤100 ml/24h시발제인류관（상규조）。기록량조환자술후흉강인류량、인류관류치시간、술후주원시간、술후급발관후흉부병발증발생정황。결과개진조환자술후시각모의평분법（VAS）평분저우상규조（P＜0.01），술후24소시흉강인류량략저우상규조（P＞0.05），흉강인류관류치시간급주원시간균명현단우상규조（P＜0.05）。량조환자술후급발관후흉부병발증발생솔비교차이균무현저성（P＞0.05）。결론폐협절제술후단관흉강인류시유효적，장발제흉강인류관적지정설정위인류량≤300 ml/24h시가행적，병불증가술후흉부병발증발생솔，유리우환자술후적쾌속강복。
ObjectiveTo evaluate the feasibility and safety of improving chest drainage procedure after lobectomy for lung diseases in fast track recovery.MethodPatients who underwent lobectomy were included in this study, they were randomly divided into improved group including 88 patients (single chest tube and removal of chest tube when drainage volume less than 300 ml/24h) and conventional group including 78 patients (double chest tube and removal of chest tube when drainage volume less than 100 ml/24h). Drainage volume, intubation time, postoperative hospital stay and thoracic complications after removal chest tubes were compared between the two groups.ResultVAS scores and drainage volume within 24 hours after surgery were not signiifcantly different between the two groups (P>0.05), intubation time and hospital stay of improved group were shorter than conventional group (P<0.05), there was no signiifcant difference of thoracic complications rate between the two groups.ConclusionSingle chest tube is the same effective as the double chest tubes. The early removal of chest tube after lobectomy (drainage≤300 ml/24h) is feasible andsafe, it does not increase thoracic complications rates, and is beneifcial to fast track recovery.