高毅哲　林伟鹏　钟宏源　叶学超　李占清

【摘要】 目的：探讨上肺叶切除术后单根胸管引流的可行性。方法：选取2017年5月-2019年3月在厦门医学院附属第二医院行胸腔镜上肺叶切除术的患者78例，随机分成观察组（单根胸管）及对照组（两根胸管），各39例，比较引流量、胸管留置时间、术后住院天数、再次置管或穿刺率、肺部感染发生率及疼痛程度等指标。结果：在疼痛评分、胸腔引流管留置时间及术后住院天数上，观察组均低于对照组，差异有统计学意义（P<0.05）;而术后引流量、再次胸穿或置管、肺部感染、皮下气肿等差异无统计学意义（P>0.05）。结论：单根胸管在上肺叶切除术后引流能够减轻患者疼痛，缩短胸管留置时间以及住院天数，并且不增加术后并发症，值得在临床上推广。

【关键词】 上肺叶切除 单根胸管 可行性

doi：10.14033/j.cnki.cfmr.2020.18.009 文献标识码 B 文章编号 1674-6805（2020）18-00-03

Feasibility Analysis of Single Thoracic Tube after Upper Lobectomy of Lung/GAO Yizhe， LIN Weipeng， ZHONG Hongyuan， YE Xuechao， LI Zhanqing. //Chinese and Foreign Medical Research， 2020， 18（18）： -22

[Abstract] Objective： To explore the feasibility of single thoracic tube after upper lobectomy. Method： Seventy-eight patients who underwent thorccoscopic upper lobectomy in the Second Affiliated Hospital of Xiamen Medical College from May 2017 to March 2019 were randomly divided into observation group （single thoracic tube） and control group （two thoracic tubes） with 39 cases in each group. The amount of post-operation drainage， retention time of thoracic tube， hospital days after operation， re-placement of thoracic tube or puncture rate， pulmonary infection， and the degree of pain were compared between two groups. Result： The pain score， drainage retention time of thoracic tube and the hospital days after operation in the observation group were significantly lower than those in the control group （P<0.05）. However， there was no significant difference in postoperative drainage， re thoracotomy or catheterization， pulmonary infection and subcutaneous emphysema （P>0.05）. Conclusion： Single thoracic drainage after upper lobectomy can reduce patients ache， shorten the duration of thoracic drainage and the hospital days after operation without increasing postoperative complications. It is worth spreading in the clinical application.

[Key words] Upper lobectomy of lung Single thoracic tube Feasibility

First-authors address： Second Affiliated Hospital of Xiamen Medical College， Xiamen 361021， China

近幾年来，肺癌的发病率明显上升，严重威胁人类的生命与健康。有资料显示，肺癌已经成为世界上发病和死亡例数最高的恶性肿瘤，而针对早期肺癌，手术仍然是首选的治疗方式[1]。电视胸腔镜肺叶切除（VATS）+纵隔淋巴结清扫已经成为肺癌根治的标准手术方式[2]，传统的观点认为肺叶切除尤其是上叶切除的手术需留置两根引流管，上管置于胸顶以排出积气，下管置于胸腔的后下方以排出积液[3]。随着近年来快速康复理念的推广和普及，微创技术的不断进步，能否仅留置单根引流管代替两根引流管以达到加快患者康复的目的？我们通过对78例上肺叶切除+纵隔淋巴结清扫术的患者单根及两根胸腔引流管的对比，进一步分析肺叶切除术后单根胸管引流的可行性。……