胸腔镜肺楔形切除术后免放置胸腔引流管的有效性及安全性评估

Assessment of Effectiveness and Safety of Chest Drainage Tube Avoidance after VATS Pulmonary Wedge Resection

摘要: 目的：探讨胸腔镜肺楔形切除术后免放置胸腔闭式引流管的临床应用价值，评估免放置胸腔引流管在临床应用中的安全性及有效性。方法：回顾性分析108例行胸腔镜下肺楔形切除术的患者临床资料，根据术后是否放置胸腔引流管分为有管组54例，无管组54例。比较两组患者的手术时间(min)、手术出血量(ml)、住院时间(天)、住院费用(万元)、术后并发症总发生率和术后第一至四天VAS疼痛评分。结果：无管组手术时间，住院费用及住院时间明显少于有管组(P均˂0.05)，两组术中出血量差异无统计学意义(P > 0.05)。无管组与有管组术后并发症总发生率差异无统计学意义(P > 0.05)。无管组术后第一，第二，第三，第四天VAS疼痛评分均明显低于有管组(P均˂0.05)。结论：胸腔镜下肺楔形切除术后免放置胸腔引流管可以减少手术时间，减少患者住院费用，减轻患者术后疼痛，加快患者术后恢复时间，且并不会增加术后并发症发生率，在临床应用中是安全有效的。

Abstract: Objective: To evaluate the efficacy and safety of omitting chest drainage tubes after video-assisted thoracoscopic surgery (VATS) for pulmonary wedge resection. Methods: A retrospective analysis was conducted on the clinical data of 108 patients who underwent VATS pulmonary wedge resection. The patients were divided into two groups based on whether a chest drainage tube was placed postoperatively: the chest tube group (n = 54) and the no-chest tube group (n = 54). Perioperative indicators were compared between the two groups, including operation time (min), intraoperative blood loss (ml), hospital stay (days), hospital costs (ten thousand yuan), total incidence of postoperative complications, and VAS pain score on the first to fourth postoperative days were compared between the two groups of patients. Results: The operation time, hospital stay, and hospital costs in the no-chest tube group were significantly shorter/lower than those in the chest tube group (P < 0.05), while there was no significant difference in intraoperative blood loss between the two groups (P > 0.05). There was no statistically significant difference in the overall incidence of postoperative complications between the tubeless group and the tube-containing group (P > 0.05). The VAS pain scores of the no-chest tube group on the first, second, third, and fourth postoperative days were significantly lower than those of the chest tube group (all P < 0.05). Conclusion: Omitting chest drainage tubes after VATS pulmonary wedge resection can reduce operation time, hospital stay, and hospital costs, alleviate postoperative pain, and promote the rapid recovery of patients without increasing the incidence of postoperative complications. It is safe and effective in clinical application.