肺切除后无胸管适应症的临床研究

Clinical Indication Analysis of Avoiding Chest Tube Placement after Lobectomia Pulmonalis

摘要: 目的：探讨肺叶切除后不放置胸管在肺外科快速康复中应用的适应症。方法：选取2016年7月~2018年6月于我院实施完全胸腔镜肺叶切除共104例，随机分为研究组与对照组进行临床对比。结果：两组患者平均手术时间、淋巴结清扫情况、术中平均出血量无明显差异(P > 0.05)。研究组术后住院时间、并发症发生率低于对照组，差异有统计学意义(P < 0.05)。研究组在术后第1天及术后第3天的VAS评分相对对照组低，差异有统计学意义(P < 0.05)。研究组术后第2日、术后第7日、术后1月肺复张情况优于对照组，差异有统计学意义(P < 0.05)。结论：肺叶切除后不放置胸管创伤小、疼痛明显减轻，可加快术后康复，降低并发症发生，具有推广意义。

Abstract: Objective: To explore the clinical Indication after lobectomia pulmonalis. Methods: Clinical data of 50 parents who were treated with lobectomia pulmonalis without chest tube placement in our hospital from July 2016 to June 2018 were selected as research group, compared with 47 parents who were treated with lobectomia pulmonalis with chest tube placement during the same period as control group. Results: There were no statistically significant differences in the average surgery time, number of dissected lymph nodes, average amount of bleeding between the two groups (P > 0.05). The research group had lower postoperative hospital stay and complication rate than control group. Vas score 1 day and 3 days after the surgery in the research group both were lower than the control group. The research group had better lung recruitment than the control group in the 1 day, 7 days and 1 month after operation. The differences were significant (P < 0.05). Conclusion: Avoiding chest tube placement after lobectomia pulmonalis has advantages of small trauma after surgery, and its conditions during the surgery are similar.