[1]赖习华 吴稚晖 陈广 彭静 江威霖 李文灿*.无管化与常规双腔气管插管单孔胸腔镜肺大疱切除术的比较[J].中国微创外科杂志,2019,01(11):993-1003.
　Lai Xihua,Wu Zhihui,Chen Guang,et al.Comparison Between Tubeless and Routine Double Lumen Endotracheal Intubation for Singleport Thoracoscopic Pulmonary Bullae Resection[J].Chinese Journal of Minimally Invasive Surgery,2019,01(11):993-1003.
点击复制

无管化与常规双腔气管插管单孔胸腔镜肺大疱切除术的比较()
分享到：

《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2019年11期
页码:
993-1003
栏目:
临床研究
出版日期:
2019-11-25

文章信息/Info

Title:
Comparison Between Tubeless and Routine Double Lumen Endotracheal Intubation for Singleport Thoracoscopic Pulmonary Bullae Resection
作者:
赖习华 吴稚晖 陈广 彭静 江威霖 李文灿*
（中南大学湘雅医学院附属株洲医院心胸外科，株洲412000）
Author(s):
Lai Xihua;  Wu Zhihui;  Chen Guang;  et al.
Department of Cadiothoracic Surgery, The Affiliated Zhuzhou Hospital of Xiangya School of Medicine CSU, Zhuzhou 412000, China
关键词:
无管化; 单孔胸腔镜; 肺大疱切除; 快速康复
Keywords:
Tubeless; Singleport thoracoscopy; Pulmonary bullae resection; Rapid recovery
文献标志码:
A
摘要:
目的探讨无管化操作在单孔胸腔镜肺大疱切除术中的安全性及可行性。方法回顾性分析我院2016年8月~2017年11月单纯自发性气胸行单孔胸腔镜肺大疱切除术44例，A组22例（无管化单孔），B组22例（常规双腔气管插管），比较2组手术时间、出血量、术后疼痛评分、气道不适及住院时间等指标。结果A组22例均顺利完成无管化单孔胸腔镜肺大疱切除手术，1例因术后气胸再次留置胸腔引流管后复张，其余患者均术后顺利康复出院。2组手术时间、出血量差异均无显著性（P>0.05）。A组术后住院时间（2.2±0.8）d，显著短于B组（3.3±0.8）d（t=-4.543，P=0.000）；A组术后疼痛VAS评分（3.1±0.6）分,明显低于B组（4.1±0.9）分（t=-4.283，P=0.000）；A组术后气道不适发生率9.1%（2/22）,明显低于B组50.0%（11/22）（χ2=8.844，P=0.003）。结论对年轻自发性气胸单纯肺大疱患者采用无管化单孔胸腔镜肺大疱切除手术是安全可行的，术后患者胸部切口疼痛感降低，气管舒适性、尿道舒适性良好，住院时间缩短，符合肺大疱切除快速康复理念，可以进一步开展应用。
Abstract:
ObjectiveTo investigate the safety and feasibility of tubuless performance in singleport thoracoscopic pulmonary bullae resection.Methods A retrospective analysis was made on 44 patients with spontaneous pneumothorax hospitalized between August 2016 and November 2017. The group A (22 cases) was treated with tubeless singleport thoracoscopic pulmonary bullae resection. The group B (22 cases) was treated with conventional tracheal intubation singleport thoracoscopic surgery. The operation time, blood loss, postoperative pain scores, tracheal discomfort and hospitalization time were compared between the two groups.ResultsThe 22 patients in the group A successfully underwent tubeless singleport thoracoscopic pulmonary bullae resection. Except for one patient with atelectasis who was given left chest indwelling drainage again, the other patients were successfully discharged. There was no significant difference in operation time and blood loss between the two groups (P>0.05). As compared to the group B, the group A had shorter postoperative hospitalization time ［(2.2±0.8) d vs. (3.3±0.8) d, t=-4.543, P=0.000］, lower pain scores ［(3.1±0.6) points vs. (4.1±0.9) points, t=-4.283, P=0.000］, and lower incidence of tracheal discomfort ［9.1% (2/22) vs. 50.0% (11/22), χ2=8.844, P=0.003］.ConclusionsIt is safe and feasible for young patients with spontaneous pneumothorax and simple bullae to use the tubeless singleport thoracoscopic pulmonary bullae resection. After the operation, the patients’ chest incision pain is reduced, the trachea comfort and urethra comfort are good, the hospital stay is shortened, which is in line with the concept of rapid recovery of bullae resection, and can be further applied in clinical practice.

参考文献/References:

[1]孙涛,傅卫.快速康复外科的现状与展望.中国微创外科杂志,2007,7(6):564-566.
[2]蔡开灿,王向东,叶靖，等.喉罩全麻与气管插管全麻胸腔镜手术治疗肺大疱的临床对照研究.南方医科大学学报,2013,33(5):756-760.
[3]Liu J，Cui F，Pompeo E，et al．The impact of nonintubated versus intubated anaesthesia on early outcomes of videoassisted thoracoscopic anatomical resection in nonsmallcell lung cancer: a propensity score matching analysis．Eur J Cardiothorac Surg,2016,50(5):920-925．
[4]江志伟,黎介寿.快速康复外科——优化的临床路径.中华胃肠外科杂志,2012,15(1):12-13.
[5]Nanavati AJ, Prabhakar S. Fasttrack surgery: Toward comprehensive perioperative care. Anesth Essays Res,2014,8(2):127-133.
[6]Cerfolio RJ. Call it “fast tracking” or “enhanced recovery pathways”-No matter the name, it ain’t nothing new to thoracic surgeons. J Thorac Cardiovasc Surg,2017,154(6):2091.
[7]Gonzalez D, Bonome C，Fieira E，et al．Nonintubated videoassisted thoracoscopic lung resections: the future of thoracic surgery. Eur J Cardiothorac Surg,2016,49(3):721-731．
[8]车国卫,刘伦旭.单孔电视胸腔镜手术临床应用的现状与进展.中国胸心血管外科临床杂志,2012,19(2):181-184.
[9]刘鸿运,白舒,丁国强,等.单孔胸腔镜手术治疗自发性气胸合并肺大疱.中国实用医药,2014,9(26):115-116.
[10]温佳新,初向阳.单孔胸腔镜手术在自发性气胸治疗中的应用.中国内镜杂志,2012,18(4):428-429.
[11]毛松松,马珏.喉罩和气管内插管在成人NUSS手术麻醉中的对照研究.广东药学院学报,2014,30(3):366-369,372.

备注/Memo

备注/Memo:
*通讯作者，Email：312076762@qq.com
更新日期/Last Update: 2020-03-03