中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

肺部手术后数字式胸腔引流系统与传统三联瓶引流的病例对照研究

查看全文

目的 比较数字式胸腔引流系统与传统三联瓶引流在肺部手术后患者的应用效果,探讨数字式胸腔引流系统的优势。 方法 回顾性分析 2016 年 9 月至 2017 年 5 月北京大学国际医院胸外科 42 例肺部手术患者的临床资料,其中男 30 例、女 12 例,年龄 34(19~81)岁。术后采用 Thopaz 数字引流装置患者 21 例(digital drainage system,DDS 组),传统三联瓶引流患者 21 例(traditional drainage system,TDS 组),观察术后治疗效果。比较两组患者的漏气时间、术后带管时间、住院时间、48 h 引流量及住院费用。 结果 两组患者均顺利出院,与 TDS 组相比,DDS 组的术后漏气时间、术后带管时间及住院时间明显缩短[(35.6±16.3)h vs.(48.2±20.1)h,P=0.02;(50.0±16.1)h vs. (62.0±20.4)h,P=0.03;(5.9±2.3)d vs. (7.8±3.5)d,P=0.02],48 h 引流量及总住院费用差异无统计学意义。 结论 肺部手术后采用数字引流系统可以明显缩短患者术后漏气时间及术后引流管留置时间,同时不增加总住院费用。

Objective To compare the digital drainage system and the traditional drainage system in the patients after lung surgery, and to evaluate the advantages of digital drainage system. Methods A retrospective analysis of consecutive 42 patients with lung surgery between September 2016 and May 2017 in Beijing University International Hospital was done. There were 30 males and 12 females with a median age of 34 years ranging 19-81 years. After the surgery 21 patients adopted Thopaz digital drainage device (a DDS group), and the other 21 patients adopted traditional drainage (a TDS group). Duration of air leakage and chest tube placement, length of hospital stay, thoracic drainage volume within 48 h and hospitalization expenses in the two groups were compared. Results The patients in the two groups were all successfully discharged. Compared with the TDS group, duration of air leakage and chest tube placement and length of hospital stay significantly shortened in the DDS group (35.6±16.3 h vs. 48.2±20.1 h, P=0.02; 50.0±16.1 h vs. 62.0±20.4 h, P=0.03; 5.9±2.3 d vs. 7.8±3.5 d, P=0.02), and thoracic drainage volume within 48 h and hospitalization expenses showed no significant statistical difference between the two groups. Conclusion Using digital drainage system after lung surgery can significantly shorten the duration of air leakage and the postoperative drainage, at the same time, without increasing the overall hospitalization expenses.

关键词: 数字引流系统; 胸腔镜手术; 加速康复外科

Key words: Digital drainage system; thoracoscopic surgery; enhanced recovery after surgery

引用本文: 张洪斌, 陆超, 梁正. 肺部手术后数字式胸腔引流系统与传统三联瓶引流的病例对照研究. 中国胸心血管外科临床杂志, 2018, 25(4): 289-292. doi: 10.7507/1007-4848.201706003 复制

登录后 ,请手动点击刷新查看全文内容。 没有账号,
登录后 ,请手动点击刷新查看图表内容。 没有账号,
1. French DG, Dilena M, LaPlante S, et al. Optimizing postoperative care protocols in thoracic surgery: best evidence and new technology. J Thorac Dis, 2016, 8(Suppl 1): S3-S11.
2. Slim K. The benefits of enhanced recovery after surgery. J Visc Surg, 2016, 153(6S): S41-S44.
3. Afoke J, Tan C, Hunt I, et al. Might digital drains speed up the time to thoracic drain removal? Interact Cardiovasc Thorac Surg, 2014, 19(1): 135-138.
4. Bintcliffe OJ, Hallifax RJ, Edey A, et al. Spontaneous pneumothorax: time to rethink management? Lancet Respir Med, 2015, 3(7): 578-588.
5. Ono M, Komiya K, Oka H, et al. Prognosis of pneumothorax in elderly patients treated with thoracic drainage. J Palliat Med, 2014, 17(11): 1197-1198.
6. Mesa-Guzman M, Periklis P, Niwaz Z, et al. Determining optimal fluid and air leak cut off values for chest drain management in general thoracic surgery. J Thorac Dis, 2015, 7(11): 2053-2057.
7. George RS, Papagiannopoulos K. Advances in chest drain management in thoracic disease. J Thorac Dis, 2016, 8(Suppl 1): S55-S64.
8. Brunelli A, Cassivi SD, Salati M, et al. Digital measurements of air leak flow and intrapleural pressures in the immediate postoperative period predict risk of prolonged air leak after pulmonary lobectomy. Eur J Cardiothorac Surg, 2011, 39(4): 584-588.
9. Gilbert S, McGuire AL, Maghera S, et al. Randomized trial of digital versus analog pleural drainage in patients with or without a pulmonary air leak after lung resection. J Thorac Cardiovasc Surg, 2015, 150(5): 1243-1249.
10. Mier JM, Molins L, Fibla JJ, The benefits of digital air leak assessment after pulmonary resection: prospective and comparative study. Cir Esp, 2010. 87(6): 385-389.
11. Cafarotti S, Cusumano G, Giuliani M, et al. Extra-anatomical VATS lung resection: the outpatient experience with the aid of a digital chest drain device. Eur Rev Med Pharmacol Sci, 2015, 19(20): 3850-3854.
12. Costa AD Jr, Bachichi T, Holanda C, et al. An initial experience with a digital drainage system during the postoperative period of pediatric thoracic surgery. J Bras Pneumol, 2016, 42(6): 444-446.
13. Rathinam S, Bradley A, Cantlin T, et al. Thopaz Portable Suction Systems in Thoracic Surgery: an end user assessment and feedback in a tertiary unit. J Cardiothorac Surg, 2011, 6: 59.
14. Mier JM, Cortés-Julián G, Berrios-Mejía J, et al. The benefits of digital chest drainage in pleural decortication in thoracic empyema. Prospective, randomized, control trial. Cir Cir, 2017, 85(6): 522-525.
15. Cortés Julián G, Mier JM, Iñiguez MA, et al. Right main bronchial fracture resolution by digital thoracic drainage system. Asian Cardiovasc Thorac Ann, 2016, 24(3): 283-285.
16. Tsim S, Paton L, Nicholson F, et al. Rescue therapy using an endobronchial valve and digital air leak monitoring in Invasive Pulmonary Aspergillosis. Respir Med Case Rep, 2014, 14: 27-29.
17. Tang H, Pan T, Qin X, et al. A portable thoracic closed drainage instrument for hemopneumothorax. J Trauma Acute Care Surg, 2012, 72(3): 671-675.
18. Pompili C, Brunelli A, Salati M, et al. Impact of the learning curve in the use of a novel electronic chest drainage system after pulmonary lobectomy: a case-matched analysis on the duration of chest tube usage. Interact Cardiovasc Thorac Surg, 2011, 13(5): 490-493.