胸腔镜肺段切除术后基于8 h胸腔引流量早期拔管的安全性与可行性研究

Safety and feasibility of early thoracic tube removal based on 8-hour pleural drainage volume after thoracoscopic segmentectomy

摘要:

目的 探讨胸腔镜肺段切除术后根据连续8 h胸腔引流量（PDV）拔除胸腔引流管的可行性和安全性。方法 回顾性分析2022年7月1日－2024年6月30日于该院接受胸腔镜肺段切除术的360例肺结节患者的临床资料。根据8 h PDV拔除胸腔引流管的患者设为8 h组（173例），根据24 h PDV拔除胸腔引流管的患者设为24 h组（187例）。比较两组患者手术相关情况和术后并发症。结果 两组患者手术肺叶、手术时间、术中出血量、清扫淋巴结站数、清扫淋巴数量和术后病理比较，差异均无统计学意义（P > 0.05）。8 h组术后胸腔引流管留置时间和术后住院时间明显短于24 h组，差异均有统计学意义（P < 0.05）。两组患者再次引流率和切口愈合不良率比较，差异均无统计学意义（P > 0.05）。结论 胸腔镜肺段切除术后，根据8 h PDV拔除胸腔引流管是安全的，具有一定可行性。与传统的根据24 h PDV拔除胸腔引流管方案相比，该方法可更早地拔除胸腔引流管，缩短住院时间。值得临床推广应用。

Abstract:

Objective To explore the feasibility and safety of removing the thoracic tube based on continuous 8-hour pleural drainage volume (PDV) after thoracoscopic segmentectomy.Methods A retrospective analysis was conducted on the clinical data of 360 patients with pulmonary nodules who underwent thoracoscopic pulmonary segmental resection from July 1, 2022 to June 30, 2024. Patients with thoracic tube removal based on 8-hour PDV were set as the 8-hour group (173 cases), and patients with thoracic tube removal based on 24-hour PDV were set as the 24-hour group (187 cases). Compare the surgery-related conditions and postoperative complications of the two groups of patients.Results There were no statistically significant differences between the two groups of patients in terms of surgical lung lobes, operation time, intraoperative blood loss, the number of lymph node stations dissected, the number of lymph nodes dissected, and postoperative pathology (P > 0.05). The indwelling time of the thoracic tube and the postoperative hospital stay in the 8-hour group were significantly shorter than those in the 24-hour group, and the differences were statistically significant (P < 0.05). There was no statistically significant difference in the rates of re-drainage and poor incision healing between the two groups of patients (P > 0.05).Conclusion It may be safe and feasible to remove the thoracic tube based on 8-hour PDV after thoracoscopic segmental resection of the lung. Compared with the traditional plan of removing the thoracic tube based on the 24-hour PDV, this method can remove the thoracic tube earlier and shorten the hospital stay. It is worthy of clinical promotion and application.