胸腔镜下右肺上叶切除术中松解下肺韧带对余肺术后代偿性膨胀的影响
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昌邑市人民医院

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Effects of releasing inferior pulmonary ligament in resecting right upper lobe of the lung under thoracoscope on postoperative compensatory dilation of the rest lung
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    摘要:

    【】 目的 探讨胸腔镜下右肺上叶切除术的患者,术中松解下肺韧带是否会对术后余肺代偿性膨胀产生影响。 方法 2010年1月至2014年6月,100例右肺上叶肺癌患者在我科行胸腔镜下右肺上叶切除术,随机分为两组,即试验组(非松解组)50人,胸腔镜下右上肺切除术中不松解下肺韧带;对照组(松解组)50人,胸腔镜下右上肺切除术中松解下肺韧带。观察术后两组患者的术后右侧余肺代偿性膨胀情况,每日胸腔引流量及引流总量、平均拔管时间及术后住院时间。 结果 术后两组患者残腔液平面存留比率进行统计学比较,未出现显著性差异(P>0.05),平均胸腔引流量亦不具有显著性(P>0.05)。此外实验组与对照组胸腔引流管的平均拔管时间、胸腔穿刺例数和次数以及术后住院时间亦均不存在显著性差异(P>0.05)。结论 胸腔镜下右肺上叶切除术中可不必松解下肺韧带,不会影响患者术后的恢复,不会延长患者住院时间。 适合在临床推广。

    Abstract:

    Objective To discuss if the intraoperative releasing inferior pulmonary ligament would affect the postoperative compensatory dilation of the residual lung in the patients going through the resection of the upper lobe under the thoracoscope. MethodFrom January 2010 to June 2014, 100 patients with lung cancer of right upper lobe were undergone resection of the upper lobe under thoracoscope in our department. They were randomly divided into two groups, the experimental group( the non-released group) with 50 people who were not released inferior pulmonary ligament during resection of the right upper lobe under thoracoscope. The control group(the released group) with 50 people who were released inferior pulmonary ligament during resection of the right upper lobe under thoracoscope. Observed the amount of daily thoracic cavity drainage, total drainage, the average extubation time and length of stay after the operation. Results Statistically compare postoperative residual cavity fluid level reserved rate of two groups of patients.There does not exist significant difference (P > 0.05) and the average drainage on the chest also is not significant (P > 0.05). Besides, there does not exist significant difference (P > 0.05) in the average time of decannulation of chest drainage tube, pleural biopsy cases and times, and postoperative hospital stay between two groups either. ConclusionIt’s unnecessary to release the inferior pulmonary ligament during resection of the right upper lobe under thoracoscope, which will not affect postoperative recovery and prolong length of hospital stay. Therefore it’s suitable for clinical promotion.

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  • 收稿日期:2015-04-14
  • 最后修改日期:2015-10-16
  • 录用日期:2015-11-25
  • 在线发布日期: 2016-01-22
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