关键词: 胸管, 引流术, 胸腔积液, 胸腔镜检查,  , 肺切除术

Abstract: ObjectiveTo evaluate the clinical effects of thoracic close drainage with thin drainage tube assisted to thick drainage tube after videoassisted thoracic surgery (VATS) lobectomy.MethodsWe retrospectively reviewed 89 patients received VATS lobectomy in Chinese PLA General Hospital from January 2014 to September 2014. The patients with nonsmall cell lung cancer were divided into two groups: treatment group (50 patients) and control group (39 patients). Treatment group took thin tube assisted to thick tube of thoracic close drainage and control group took general thoracic closed drainage tube. We studied the operation time, the bleeding of operation, the number of lymph node dissection, time of first activity out of bed，the hospitalization time of postoperation, postoperative complications, the days of postoperative drainage, drainage volume, the effect of drainage, the VAS evaluation score of postoperative pain in the two groups. ResultsCompared with control group, there was no statistical significance in the differences of the time of operation ［(2.58±0.57) h vs (2.57±0.50) h; t=0.127, P=0.681］, bleeding of operation ［(108.00±52.84) ml vs (114.10±107.18) ml; t=0.352, P=0.334］, the number of lymph node dissection ［(14.20±5.95) vs (11.21±4.71); t=2.576, P=0.068)］, the staying time of drainage ［(5.66±2.53) d vs (5.82±2.02) d; t=0.324, P=0.219］, the postoperative drainage volume ［(1 141.76±819.26) ml vs (1 022.95±464.84) ml; t=0.889, P=0.367］ and the occurrences of the postoperative complications (8.00% vs 10.25%; χ2=1.750, P=0.726). There was statistical significance in the differences of the postoperative time of offbed ［(11.28±8.78) h vs (13.97±7.83) h; t=4.027, P=0.045］, the time from surgery to discharge ［(8.36±2.63) d vs (9.56±2.89) d; t=2.952, P=0.043］ and the drainage effect（costophrenic angle sharp: 72.0% vs 46.2%; χ2=5.329, P=0.017). In the two groups, there were statistical significance differences in scores of VAS for the 24 to 72 hours resting and coughing of postoperation: 24 h ［(2.78±1.13) vs (3.74±1.68); t=3.226, P＜0.001)］, 48 h ［(1.98±0.59) vs (3.33±1.72); t=5.189, P＜0.001)］, 72 h ［(1.94±0.55) vs (3.15±1.60); t=5.010, P＜0.001)］, coughing ［(3.64±1.23) vs (5.33±1.95); t=5.005, P＜0.001)］. ConclusionThe thin drainage tube assisted to thick drainage tube for thoracic close drainage make the drainage more effective, release the pain, shorten the hopital stay; moreover, it is simple and safe for operation and easy to popularize with high modified value.

Key words: Chest tubes, Drainage, Pleural effusion, Thoracoscopy, Pneumonectomy