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目的探讨胸腔镜肺叶切除术后16F和28F引流管对患者术后舒适度的影响。方法 2014年2~5月我院连续收治163例肺癌患者,其中男70例、女93例,行VATS肺叶切除术。按引流管大小将患者分为两组:28F组,应用引流管28F,75例,年龄(53.18±14.73)岁;16F组,88例,年龄(56.62±12.62)岁。根据患者术后疼痛、心率、呼吸频率和活动度(日常生活能力)来评价患者舒适度。结果两组患者临床特征及手术方式相似。16F组术后第1 d、2 d、3 d心率变化幅度均低于28F组,且差异有统计学意义[(9.67±3.33)次/分vs.(18.54±5.33)次/分,P=0.037;(7.89±2.88)次/分vs.(19.01±4.67)次/分,P=0.045;(7.67±3.01)次/分vs.(20.88±5.34)次/分,P=0.021]。术后3天内,16F组轻度疼痛患者比例(77.65%vs.49.78%,P=0.023)、自主下床活动患者比例(67.05%vs.45.78%,P=0.023)、(67.05%vs.55.11%,P=0.026)均高于28F组,且差异有统计学意义。结论胸腔镜肺叶切除术后应用细引流管有助于提高术后患者舒适度。
Objective To investigate the postoperative comfort of 16F and 28F drainage tubes after thoracoscopic lobectomy. Methods From February to May 2014, 163 consecutive patients with lung cancer were admitted to our hospital, including 70 males and 93 females. VATS lobectomy was performed. According to the size of the drainage tube, the patients were divided into two groups: group 28F, drainage tube 28F, 75 cases (53.18 ± 14.73) years of age, and group 16F (88 cases, 56.62 ± 12.62 years). Patient comfort was assessed based on postoperative pain, heart rate, respiratory rate and activity (daily living ability). Results The clinical features and surgical methods of the two groups were similar. The changes of heart rate in group 16F at 1 d, 2 d and 3 d after operation were lower than those in group 28F ([(9.67 ± 3.33) / min vs (18.54 ± 5.33) / min, P = 0.037; (7.89 ± 2.88) beats / min vs. 19.01 ± 4.67 beats per minute, P = 0.045; (7.67 ± 3.01) beats / min vs. 20.88 ± 5.34 beats per minute, P = 0.021]. Within 3 days after operation, the proportion of patients with mild pain in group 16F (77.65% vs.49.78%, P = 0.023), the rate of spontaneous ambulation (67.05% vs.45.78%, P = 0.023), (67.05% vs.55.11 %, P = 0.026) were higher than 28F group, and the difference was statistically significant. Conclusions The application of a thin drainage tube after thoracoscopic lobectomy can improve postoperative comfort.