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安全性的病例对照研究

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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 2013 年 7 月至 2017 年 7 月我院 201 例风湿性心脏病(风心病)瓣膜置换术后患者,其中男 57 例、女 144 例,年龄 15~72 岁。根据拔管前 24 h 引流量将患者分为两组:引流量≤50 ml 组(组 1,127例)及>50 ml 组(组 2,74 例),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,且拔管后均无心脏压塞等严重并发症发生,而组 2 患者术后住院时间短于组 1,差异有统计学意义(8.0 dvs.7.5 d,P=0.013)。 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(24 h 引流量>50 ml)拔除心包纵隔引流管,不仅缩短了住院时间,而且不会提高心脏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 Between July 2013 and July 2017, 201 patients with rheumatic heart disease (CHD) were treated with valve replacement in our hospital, including 57 males and 144 females, aged 15 to 72 years. They were divided into two groups according to the amount of 24-h drainage before the drain removal: a group one with 24-h drainage volume≤50 ml (n=127) and a group two with 24-h drainage volume>50 ml (n=74). The postoperative hospital stay and the incidence of severe complications between the two groups were compared. Results There was no difference between the two groups in the baseline information or the incidence of severe pericardial effusion and tamponade, while the group two tended to have a shorter length of hospital stay after surgery (8.0 dvs.7.5 d, P=0.013). Conclusion In CHD patients undergoing valvular surgery, compared with a relatively low amount of drainage before the drain removal, drawing the tube at a greater amount of drainage (24-h drainage volume>50 ml) will shorten the length of hospital 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; 引流管拔管

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

引用本文: 张泰隆, 武忠, 秦小力, 古君. 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安全性的病例对照研究. 中国胸心血管外科临床杂志, 2019, 26(1): 63-66. doi: 10.7507/1007-4848.201804013 复制

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