中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

风湿性心脏病瓣膜置换术后不同引流量下拔除心包纵隔引流管的安全性研究

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目的 评估心脏手术后不同引流量下拔除心包纵隔引流管的安全性及对患者预后的影响。 方法 连续纳入 201 例风湿性心脏病(风心病)瓣膜置换术后患者并根据拔管前 24 h 引流量将患者分为两组:引流量>50 ml(组 1)组及≤50 ml 组(组 2),比较两组患者的术后住院时间以及严重并发症的发生率。 结果 两组患者临床特征及手术方式相似,且拔管后均无心包压塞等严重并发症发生,而组 1 患者术后住院时间短于组 2,差异有统计学意义(8 dvs.7.5 d,P=0.009)。 结论 对于风心病瓣膜置换术后的患者,在相对较多的引流量下拔除心包纵隔引流管(24 h 引流量>50 ml),不仅缩短了住院时间,而且不会增加心包压塞等严重并发症的发生率。

Objective To assess the safety of the removal of pericardial and mediastinal drain within different drainage volume after cardiac valvular replacement surgery. Methods Two hundred and one patients undergoing valvular surgery had been consecutively conducted and were divided into two groups according to the amount of 24-h drainage before the removal. One group is the greater amount drainage removal group (24 h>50 ml) and the other is lower amount drainage removal group (24 h≤50 ml). The postoperative hospitalization time and the incidence of severe complications between the two groups were compared. Results There was no difference between two groups in the baseline information and the incidence of significant pericardial effusion or tamponade, while the greater amount drainage removal group tend to have a shorter LOS (Length of stay) after surgery (8 dvs.7.5 d, P=0.009). Conclusion In patients undergoing a rheumatic caused valvular surgery, in compared with a relatively low amount of drainage before removal, drawing the tube at a greater amount of drainage (24 h>50 ml) would shorten the length of stay after cardiac surgery while incidence of severe complications remains the same.

关键词: 心脏瓣膜手术; 心包纵隔引流管; 引流管拔管

Key words: Valvular surgery; pericardial and mediastinal drainage; drain removal

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