[1]王若天 钱坤 谭晓刚 刘磊 苏雷 李元博 姚舒洋 张毅**.2 μm铥激光肺切除术中肺断面漏气的处理[J].中国微创外科杂志,2018,18(12):1129-1136.
　Wang Ruotian,Qian Kun,Tan Xiaogang,et al.Treatment of Pulmonary Air Leakage During 2μm Thulium Laser Lung Resection[J].Chinese Journal of Minimally Invasive Surgery,2018,18(12):1129-1136.
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2 μm铥激光肺切除术中肺断面漏气的处理()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
18
期数:
2018年12期
页码:
1129-1136
栏目:
经验交流
出版日期:
2018-12-20

文章信息/Info

Title:
Treatment of Pulmonary Air Leakage During 2μm Thulium Laser Lung Resection
作者:
王若天 钱坤 谭晓刚 刘磊 苏雷 李元博 姚舒洋 张毅**
（首都医科大学宣武医院胸外科，北京100053）
Author(s):
Wang Ruotian;  Qian Kun;  Tan Xiaogang;  et al.
Department of Thoracic Surgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
关键词:
2 μm铥激光;  肺漏气
Keywords:
2μm thulium laser; Pulmonary air leakage
文献标志码:
B
摘要:
目的探讨2 μm铥激光肺切除术中肺断面漏气的处理。方法回顾性分析我科2016年1月~2018年6月应用2 μm铥激光行电视胸腔镜下肺结节切除48例资料，在气道压力30 cm H2O条件下，采用Macchiarini分级标准，0~2级漏气40例，未予特殊处理；3级漏气（大量成簇状堆积气泡）8例，2例未予处理，6例缝合修补。结果0~2级漏气40例，术后胸管引流时间17~31 h，平均28.0 h；3级漏气8例，除1例未缝合者持续漏气带管16 d外，术后胸管引流时间25~61 h，平均45.2 h。结论在2 μm铥激光肺切除术中，0~2级漏气可不予特殊处理，3级漏气需要积极手术修补。
Abstract:
ObjectiveTo investigate the treatment of pulmonary air leakage during 2μm thulium laser lung resection.MethodsA retrospective analysis was conducted on data of 48 cases of pulmonary nodule resection by videoassisted thoracoscopic surgery in our department from January 2016 to June 2018. Under 30 cm H2O airway pressure, according to the Macchiarini classification criteria, 40 patients got grade 0-2 air leakage (not surgically treated) and 8 patients got grade 3 air leakage (except for 2 cases not surgically treated, 6 patients were repaired by suture).ResultsFor the 40 patients with grade 0-2 air leakage,the thoracic tube drainage time was 17-31 h, with an average of 28.0 h. For the 8 cases of grade 3 air leakage, except for 1 case without suture having continuous air leakage for 16 days, the postoperative chest tube drainage time was 25-61 h, with an average of 45.2 h.ConclusionDuring 2μm thulium laser lung resection, grade 0-2 air leakage may not be specially treated, and grade 3 air leakage needs active surgical repair.

参考文献/References:

[1]张毅，王若天，钱坤，等.铥激光在胸腔镜下肺结节切除手术中的应用.中华胸心血管外科杂志，2017,33（6）:360-362.
[2]Brunelli A，Monteverde M，Borri A，et al.Predictors of prolonged air leak after pulmonary lobectomy.Ann Thorac Surg,2004,77(2):1205-1210.
[3]Okereke I,Murthy SC,Alster JM,et al.Characterization and importance of air leak after lobectomy.Ann Thorac Surg,2005,79(2):1167-1173.
[4]Brunelli A,Xiume F,Al Refai M,et al.Air leak after lobectomy increase the risk of empyema but not of cardiopulmonary complication:a casemathed analysis.Chest,2006,130(13):1150-1156.
[5]Varela G,Jimenez MF,Novoa N,et al.Estimating hospital cost attributable to prolonged air leak in pulmonary lobectomy.Eur J Cardiothorac Surg,2005,27(7):329-333.
[6]Marulli G，Droghetti A，Di Chiara F，et al.A prospective randomized trial comparing stapler and laser techniques for interlobar fissure completion during pulmonary lobectomy.Lasers Med Sci，2013,28（21）:505-511.

备注/Memo

备注/Memo:
基金项目：北京市医院管理局临床技术创新项目（XMLX201702）**通讯作者，Email：steven9130@sina.com
更新日期/Last Update: 2019-03-01