胸腔镜肺癌根治术后胸腔引流管管理的研究进展

Progress of thoracic drainage tube management after lung cancer with thoracoscopic radical surgery

摘要:

原发性肺癌（以下简称肺癌）是我国最常见的恶性肿瘤之一，且新发肺癌患者数以及肺癌病死 人数在我国一直居高不下。随着腔镜设备的更新，肺癌切除已从原来普通开胸手术到传统多孔胸腔镜再到单 孔胸腔镜肺叶切除、全肺切除。所有手术结束后放置胸腔引流管是胸外科手术后的一项标准程序，术后引流 管可以起到引流出胸腔内液、气的作用，还可通过引流的情况观察胸腔内的情况。随着手术安全性的提高， 患者术后康复时间、拔管时间越来越受到人们的重视。从28 F 管更换到16 F 管，由双胸腔引流管变为单胸 腔引流管，对于患者术后的康复、早期出院都有很大的帮助。通过实验发现，单孔肺叶切除术后隧道式胸腔 引流管相对缩短患者的拔管时间，更利于康复，但是单孔肺叶切除术后隧道式胸腔引流管是否适用于所有的 患者尚需进一步探讨。随着腔镜设备的更新，术后护理的进步，缩短患者术后拔管时间，带来更好的康复效果。

Abstract:

Primary lung cancer is one of the most common malignant tumors in China, and the number of new cases of lung cancer and the number of deaths from lung cancer are high in China. With the update of videoassisted thoracoscopic surgery, pneumonectomy has changed from conventional open chest surgery to traditional multi-thoracoscopic surgery, single-port thoracoscopic lobectomy and total pneumonectomy. However, the standard procedure for post-operative thoracic drainage tube is to place thoracic drainage tube at the end of all operations. Postoperative drainage tube can play a role in draining fluid and gas from the thoracic cavity to observe the situation of thoracic cavity. With the improvement of surgical safety, people pay more and more attention to the recovery time and the withdrawal time of the patients after operation. The change from 28F to 16F tube, from double thoracic drainage tube to single thoracic drainage number, is very helpful for the postoperative rehabilitation and early out of patients. It found that the tunnel type thoracic drainage tube after single-port pulmonary lobectomy has a relatively better effect on the timing and rehabilitation of the patient. Whether the tunnel type thoracic drainage tube is suitable for all sensory patients after single-port pulmonary lobectomy is a further study. Finally, with the update of the equipment and the progress of post-operative nursing, the time of announcement and the effect of rehabilitation will be improved.