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目的探究单胸管引流在非小细胞肺癌(NSCLC)微创手术患者中的应用效果。方法选取2014年1月至2016年6月于呼吸科就诊并治疗的NSCLC患者96例,随机分为对照组和试验组,每组48例。对照组男性28例,女性20例,年龄(52.18±5.63)岁,36例患者有吸烟史;试验组患者男性26例,女性22例,年龄(56.37±6.28)岁,32例有吸烟史。两组患者在性别组成、年龄分布、吸烟史比例、肿瘤大小及肿瘤的临床分期方面均无统计学差异(P均>0.05)。所有入组患者均行腹腔镜肺上叶切除加纵隔淋巴结系统性清扫微创手术,对照组患者采用双胸管引流手段,试验组受试对象采用单胸管引流方案,比较两组患者手术过程中胸腔引流量、拔管时间、日均引流量及住院时间差异;术后镇痛药服用次数、术后疼痛评分(VAS)差异;两组患者术后并发症情况。结果两组患者手术过程中出血量、胸腔引流量、拔管时间及日均引流量、住院时间均无统计学差异(P均>0.05)。试验组患者口服镇痛药的次数与注射地佐辛次数与对照比较无统计学差异(P均>0.05);但术后第二天VAS评分[(3.65±0.91)分vs(4.97±0.83)分,P<0.05]及术后1个月VAS评分[(1.21±0.61)分vs(1.83±0.62)分,P<0.05]明显低于对照组患者;试验组术后肺部感染、持续漏气及心律失常等并发症发生率较对照组有所降低,但差异无统计学意义(12.5%vs 4.2%,χ~2=1.227,P>0.05)。结论 NSCLC微创术后单胸管引流与传统双管引流效果相当,但单胸管引流创伤更小、操作更便捷,能够减轻患者术后疼痛情况,有利于患者更快痊愈。
Objective To investigate the effect of single-chest tube drainage in minimally invasive surgery for patients with non-small cell lung cancer (NSCLC). Methods A total of 96 NSCLC patients from January 2014 to June 2016 in the Department of Respiratory Medicine were randomly divided into control group and experimental group, 48 cases in each group. The control group of 28 males and 20 females, aged (52.18 ± 5.63) years, 36 patients with smoking history; test group of 26 males and 22 females, aged 56.37 ± 6.28 years old, 32 patients with smoking history. There was no significant difference in sex composition, age distribution, smoking history, tumor size and tumor clinical stage between the two groups (all P> 0.05). All patients underwent laparoscopic lobectomy combined with mediastinal lymph node dissection minimally invasive surgery, the control group of patients with dual-tube drainage means test subjects were single-chest catheter drainage program, the two groups were compared the surgical procedure Mid-thoracic drainage volume, extubation time, daily average drainage and hospitalization time; postoperative analgesic taking times, postoperative pain score (VAS) differences; two groups of patients with postoperative complications. Results There was no significant difference in bleeding, chest drainage, extubation time, daily drainage and hospital stay between the two groups (all P> 0.05). There was no significant difference in the number of oral analgesic drugs and dezocine injection between the two groups (P> 0.05). On the second day after operation, VAS score [(3.65 ± 0.91) vs (4.97 ± 0.83) P <0.05] and VAS score at 1 month (1.21 ± 0.61) vs (1.83 ± 0.62) points, P <0.05] were significantly lower than those in the control group. The pulmonary infection in the experimental group continued to leak The incidence of complications such as gas and arrhythmia was lower than that of the control group, but the difference was not statistically significant (12.5% vs 4.2%, χ ~ 2 = 1.227, P> 0.05). CONCLUSIONS: Single-chest drainage is equivalent to traditional double-tube drainage after minimally invasive surgery in NSCLC. However, single-chest drainage is less invasive and easier to operate, which can reduce postoperative pain and facilitate faster recovery.