传统胸腔引流管对胸腔镜术后疼痛的影响(1)
摘要：目的 探讨传统胸腔引流管是否会增加患者术后的疼痛。方法 将我科从2014年2月～8月行胸腔镜下肺癌根治手术的患者入组，按照开胸术后疼痛评分标准，记录患者术后当天，术后前3 d患者的疼痛评分，观察术后前3 d患者的疼痛变化趋势；分别对比拔除胸腔引流管前10 min，拔除胸腔引流管后6 h，12 h，24 h的疼痛评分，明确拔除胸腔引流管前后患者疼痛的有无明显变化。结果 入组患者38例，其中男24例，女14例，术后当天及术后前3 d的疼痛评分分别为(2.7±2.2)、(3.0±1.4)、(2.7±1.2)、(2.3±1.1)，术后当天与术后前3 d的疼痛评分无明显差异；拔管前10 min的疼痛评分为(2.2±1.0)，拔管后6 h，12 h，24 h，48 h疼痛评分分别为(1.6±0.9)、(1.4±0.7)、(1.1±0.8)、(0.8±0.6)。拔管后比拔管前10 min疼痛评分明显降低，差异有统计学意义。结论 胸腔引流管的留置明显增加术后的疼痛，如病情允许，需尽快拔除。
关键词：胸腔引流管；疼痛；开胸手术
, 百拇医药
Effects of Traditional Thoracic Drainage on Pain after Thoracoscopic Surgery
ZHANG Jia-qing，RUAN Bao-qin
(Department of Cardiothoracic Surgery，Zhujiang Hospital，Southern Medical University，Guangzhou 510280，Guangdong，China)
Abstract：Objective To investigate whether the traditional thoracic drainage tube will increase the patient's postoperative pain.Methods The patients were divided into two groups according to the criteria of thoracoscopic surgery for lung cancer from February to August in 2014.The pain scores were recorded according to the criteria of postoperative thoracotomy pain score.The pain scores of the patients were recorded on the day of the postoperative day and the first 3 d after the operation.The pain changes were observed in the first 3 days after the operation.After the thoracic drainage tube was removed for 10 min，the thoracic drainage tube was removed for 6 h，12 h，24 h pain score，clear removal of the chest before and after drainage of patients with or without significant changes in pain.Results 38 cases of patients，24 cases were male，14 were female，the day after the surgery and postoperative pain score before 3 d respectively(2.7±2.2)，(3.0±1.4)，(2.7±1.2)，(2.3±1.1)，the day after the surgery and postoperative before 3 d there were no significant differences in pain； before extubation 10 min pain score was(2.2±1.0)，after extubation 6 h，12 h，24 h，48 h pain score respectively(1.6± 0.9)，(1.4±0.7)，(1.1±0.8)，(0.8±0.6).After extubation，the pain score of 10 min was significantly lower than that before extubation，and the difference was statistically significant.Conclusion The indwelling of the thoracic drainage tube significantly increased the postoperative pain，such as the condition allows，need to be removed as soon as possible.
, 百拇医药
Key words：Thoracic drainage tube；Pain；Thoracotomy
胸腔引流管被广泛应用于引流胸腔内异常积聚的气体或液体[1]，胸腔闭式引流手术是胸外科最常见的手术。绝多数胸外科手术后需放置胸腔引流管，以引流手术后的渗液或肺部漏出的气体[2]。为保证良好的引流效果，学者们常规选择32F硅胶引流管，该引流管直径粗，质地硬，引流效果确切[3]，需在胸腔内放置一定的长度[4-6]，在胸外科越来越微创化的趋势下，全腔镜下胸外科手术，单孔腔镜下手术[7]，甚至机器人下胸外科手术逐渐出现，呈现出越来越微创的趋势。但术后应用的胸腔引流管一直选用传统的胸管，与二战时期无异。胸腔引流管是否增加术后的疼痛，是否可能進而导致并发症的上升，该类研究鲜有报道。所以我们设计了一项双盲的、观察性的研究，来明确胸外科术后胸腔引流管的留置对疼痛的影响。, http://www.100md.com(张家庆 阮宝琴)
关键词：胸腔引流管；疼痛；开胸手术
, 百拇医药
Effects of Traditional Thoracic Drainage on Pain after Thoracoscopic Surgery
ZHANG Jia-qing，RUAN Bao-qin
(Department of Cardiothoracic Surgery，Zhujiang Hospital，Southern Medical University，Guangzhou 510280，Guangdong，China)
Abstract：Objective To investigate whether the traditional thoracic drainage tube will increase the patient's postoperative pain.Methods The patients were divided into two groups according to the criteria of thoracoscopic surgery for lung cancer from February to August in 2014.The pain scores were recorded according to the criteria of postoperative thoracotomy pain score.The pain scores of the patients were recorded on the day of the postoperative day and the first 3 d after the operation.The pain changes were observed in the first 3 days after the operation.After the thoracic drainage tube was removed for 10 min，the thoracic drainage tube was removed for 6 h，12 h，24 h pain score，clear removal of the chest before and after drainage of patients with or without significant changes in pain.Results 38 cases of patients，24 cases were male，14 were female，the day after the surgery and postoperative pain score before 3 d respectively(2.7±2.2)，(3.0±1.4)，(2.7±1.2)，(2.3±1.1)，the day after the surgery and postoperative before 3 d there were no significant differences in pain； before extubation 10 min pain score was(2.2±1.0)，after extubation 6 h，12 h，24 h，48 h pain score respectively(1.6± 0.9)，(1.4±0.7)，(1.1±0.8)，(0.8±0.6).After extubation，the pain score of 10 min was significantly lower than that before extubation，and the difference was statistically significant.Conclusion The indwelling of the thoracic drainage tube significantly increased the postoperative pain，such as the condition allows，need to be removed as soon as possible.
, 百拇医药
Key words：Thoracic drainage tube；Pain；Thoracotomy
胸腔引流管被广泛应用于引流胸腔内异常积聚的气体或液体[1]，胸腔闭式引流手术是胸外科最常见的手术。绝多数胸外科手术后需放置胸腔引流管，以引流手术后的渗液或肺部漏出的气体[2]。为保证良好的引流效果，学者们常规选择32F硅胶引流管，该引流管直径粗，质地硬，引流效果确切[3]，需在胸腔内放置一定的长度[4-6]，在胸外科越来越微创化的趋势下，全腔镜下胸外科手术，单孔腔镜下手术[7]，甚至机器人下胸外科手术逐渐出现，呈现出越来越微创的趋势。但术后应用的胸腔引流管一直选用传统的胸管，与二战时期无异。胸腔引流管是否增加术后的疼痛，是否可能進而导致并发症的上升，该类研究鲜有报道。所以我们设计了一项双盲的、观察性的研究，来明确胸外科术后胸腔引流管的留置对疼痛的影响。, http://www.100md.com(张家庆 阮宝琴)
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