改良中心静脉导管在单孔胸腔镜亚肺叶切除术后引流中的应用效果

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摘要目的比较改良中心静脉导管与常规硅胶引流管胸腔闭式引流在单孔胸腔镜亚肺叶切除术后引流中的应用效果。方法选取四川省内江市第一人民医院2015年1月至2020年12月入组的104例单孔胸腔镜下亚肺叶切除术患者将其按引流管留置方式不同分为观察组（56例）和对照组（48例）。比较两组临床疗效、总引流量、引流管留置时间、人均止痛药使用次数、住院日、住院费用、切口瘢痕形成、切口满意度、术后并发症等情况。采用视觉模拟评分法（VAS），分别于术后12、24、48 h及拔管时进行评分。结果观察组术后总引流量小于对照组，胸引管留置时间、住院日短于对照组，人均止痛药使用次数少于对照组，住院费用低于对照组，差异均有统计学意义（P ＜ 0.05）。观察组手术切口瘢痕形成率低于对照组，对切口满意度高于对照组，差异有统计学意义（P ＜ 0.05）。两组12、24、48 h及拔管时VAS评分的组间、时间及交互作用比较，差异均有统计学意义（P ＜ 0.05）。进一步两两比较，组内比较：术后48 h VAS评分低于术后24、12 h，术后24 h VAS评分低于术后12 h，拔管时VAS评分高于术后48 h，差异均有统计学意义（P ＜ 0.05）；组间比较：观察组术后12、24、48 h及拔管时VAS评分均低于对照组，差异均有统计学意义（P ＜ 0.05）。两组术后并发症总发生例数比较，差异无统计学意义（P ＞ 0.05）。结论单孔胸腔镜亚肺叶切除术后使用改良中心静脉导管行胸腔闭式引流可以达到常规胸腔闭式引流管的临床效果且更具优势。

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	姚益谢晓阳李季杨彦辉王毅▲

关键词 ：单孔胸腔镜, 改良中心静脉导管, 快速康复, 胸腔引流

Abstract：Objective To compare the effect of modified central venous catheter and conventional silicone drainage tube for closed thoracic drainage after single-port thoracoscopic sublobar resection. Methods A total of 104 patients with single-port thoracoscopic sublobar resection enrolled in the First People’s Hospital of Neijiang from January 2015 to December 2020 were selected and according to different drainage tube indwelling methods, they were divided into observation group (56 cases) and control group (48 cases). The clinical efficacy, total drainage volume, drainage tube indwelling time, the average number of painkiller use, hospitalization days, hospitalization expenses, incision scar formation, incision satisfaction, and postoperative complications were compared between the two groups. Visual analogue scale (VAS) was used and scored at 12, 24, 48 h and extubation. Results The total postoperative drainage flow of the observation group was less than that of the control group, the indwelling time of chest catheter and the hospitalization days were shorter than that of the control group, the average number of painkiller use was less than that of the control group, and the hospitalization expenses was lower than that of the control group, with statistically significance (P ＜ 0.05). The incision scar formation rate in the observation group was lower than that in the control group, and the incision satisfaction was higher than that in the control group, with statistically significance (P ＜ 0.05). There were statistically significant differences in VAS score at 12, 24, 48 h and at the time of extubation between the two groups, time, and interaction (P ＜ 0.05). Further pairwise comparison: VAS score at 48 h after surgery was lower than 24 and 12 h after surgery, VAS score at 24 h after surgery was lower than 12 h after surgery, VAS score at extubation was higher than 48 h after surgery, with statistically significance (P ＜ 0.05). Comparison between groups: VAS scores of the observation group were lower than those of the control group at 12, 24, 48 h after surgery and at extubation, with statistically significance (P ＜ 0.05). There was no significant difference in the total number of postoperative complications between the two groups (P ＞ 0.05). Conclusion After single-port thoracoscopic sublobectomy, the use of modified central venous catheter for closed thoracic drainage can achieve the clinical effect of conventional closed thoracic drainage tube and has more advantages.

Key words： Single-port thoracoscopy Modified central venous catheter Rapid recovery Thoracic drainage

基金资助:四川省卫生健康委员会科研项目（20PJ289）；
四川省内江市科技计划项目（2020022）。

通讯作者: ▲通讯作者

引用本文:

姚益谢晓阳李季杨彦辉王毅▲. 改良中心静脉导管在单孔胸腔镜亚肺叶切除术后引流中的应用效果[J]. 中国医药导报, 2022, 19(8): 121-125.
YAO Yi XIE Xiaoyang LI Ji YANG Yanhui WANG Yi▲. Application effect of modified central venous catheter in drainage after single-port thoracoscopic sublobar resection#br#. 中国医药导报, 2022, 19(8): 121-125.

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https://www.yiyaodaobao.com.cn/CN/ 或 https://www.yiyaodaobao.com.cn/CN/Y2022/V19/I8/121

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