单孔胸腔镜亚肺叶切除切口原位留置粗管与细管引流的对比研究*

Comparison of in situ indwelling thick tube and thin tube drainage in uniportal VATS sublobar resection*

摘要:

单孔胸腔镜手术一般将引流管置于切口的中央或一侧，对切口的愈合有一定的影响。在创伤较小的单孔胸腔镜亚肺叶切除手术中，笔者试着采用更细的中心静脉管来代替常规胸腔引流管，并评价这种引流方式是否能够达到传统引流的效果，同时观察是否能够减少创伤加快患者的康复。方法 选取该院2016年9月－2017年3月60例单孔胸腔镜亚肺叶切除并切口原位留置引流管的患者，采用粗管和细管引流对比，对患者术后引流、拔管时间、切口愈合情况、疼痛评分和舒适评分进行比较。结果 患者无论采用粗管引流还是细管引流，术后引流量和拔管时间无差异。采用细管引流患者切口愈合优于粗管患者，并且减轻疼痛，舒适度增加。结论 对于单孔胸腔镜亚肺叶切除患者，采用原位细管引流安全有效，综合评价优于粗管引流。

Abstract:

Uniportal video-assisted thoracoscopic surgery (VATS) generally places the drainage tube in the center or side of the incision, which has a certain effect on the healing of the incision. Therefore, in the uniportal-VATS sublobar resection, we tried to replace the conventional thoracic drainage tube with a thinner central venous catheter, to see if this drainage method can achieve the effect of traditional drainage and reduce trauma and speed up the recovery of patients.?Methods?From September 2016 to March 2017, 60 uniportal-VATS sublobar patients have used thick tube and thin tube drainage randomly. Postoperative drainage, extubation time, incision healing, VAS scores, and BCS scores were compared.?Results?No matter whether the patient used thick tube drainage or thin tube drainage, there was no difference in postoperative drainage and extubation time. Incision healing in patients with thin-tube drainage is superior to that of patients with thick-tube, pain is reduced, and comfortable feeling is increased.?Conclusion?For patients with uniportal-VATS sublobar resection, in-situ thin tube drainage is safe and effective. Thin tube drainage is superior to thick tube drainage by comprehensive evaluation.