避开肋间神经闭合技术在肺癌手术中的应用价值分析

doi:10．16260/j．cnki．1009 －2188．2017．02．009

中国现代手术学杂志

2017, Vol. 21

Issue (2): 113-116 DOI: 10．16260/j．cnki．1009 －2188．2017．02．009

临床论著

避开肋间神经闭合技术在肺癌手术中的应用价值分析

丁浩，陆亚东，马春平

张家港市第一人民医院(苏州大学附属张家港医院)心胸外科，张家港215600

The Application Value of Avoiding Intercostal Nerve Closure Technique in Lung Cancer Surgery

DING Hao，LU Ya-dong，MA Chun-ping

Department of Cardiothoracic Surgery，First People ＇s Hospital of Zhangjiagang(Zhangjiagang Hospital Affiliated to Suzhou University)，Zhangjiagang 215600，Jiangsu，China

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摘要目的探讨避开肋间神经闭合技术在胸外科手术中的应用价值。方法回顾性分析2014年5月至2015年5月我院收治的94例行肺癌根治术患者，其中观察组48例，采用避开肋间神经胸腔闭合技术，对照组46例，采用常规胸腔闭合技术。比较两组的手术时间、术中出血量、术后引流量及拔除引流管时间，采用VAS疼痛评分对患者术后进行疼痛评分并行动脉血气分析。结果两组患者手术时间、术中出血量、术后引流量、拔除引流管时间，均无明显差异(P＞0．05);两组患者术后VAS疼痛评分均逐渐减轻(P＜0．05)，观察组患者在术后1 d、3 d、拔管后及1年后的疼痛评分均低于对照组(P＜0．05);对两组患者术前、术后1 d行动脉血气分析，观察组患者的PaO2明显高于对照组，PaCO2明显低于对照组(P＜0．05)，观察组和对照组术后肺部感染率分别为2．1%(1/48)和6．5%(3/46)，组间比较无明显差异(P＞0．05)。结论胸外科手术为临床中常见的手术，采用避开肋间神经闭合技术可有效减轻患者术后疼痛，并对患者PaO2及PaCO2影响较小，避开肋间神经闭合技术值得在临床推广运用。

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	丁浩，陆亚东，马春平

关键词: 避开肋间神经闭合技术开胸手术肺肿瘤

Abstract: Objective To investigate the application value of avoiding intercostal nerve closure technique in lung cancer surgery．MethodsFrom May 2014 to May 2015，94 patients who needed radical lung cancer resection were randomly divided into two groups．There were 46 patients in the control group underwent routine thoracic closure，and 48 patients in the observation group underwent avoiding intercostal nerve closure technique．The operation time，intraoperative blood loss，postoperative drainage volume and drainage time of the two groups were compared．The visual analogue scale(VAS)was used to evaluate the postoperative pain．And results of arterial blood gas were analyzed．ResultsThere was no significant difference of operation time，intraoperative bleeding volume，postoperative drainage and drainage time(P ＞ 0．05)．VAS decreased gradually in both two groups after operation(P ＜0．05)．The 1-day，3-day，post-drainage，and 1-year VAS scores of the observation group were lower than that of the control group(P ＜0．05)．PaO2of the observation group was higher than the control group 1 day after operation(P＜0．05) ，while PaCO2was significantly lower(P ＜0．05) ．The postoperative pulmonary infection rate of the observation group and the control group was 2．1%(1/48)and 6．5%(3/46)respectively，with no significant difference(P ＞0．05)．ConclusionThe thoracic closure technique avoiding intercostal nerve can effectively reduce postoperative pain，and relieve the changes of PaO2and PaCO2．

Key words: avoid intercostal nerve closure technique or edge closure technique thoracotomy lung noeplasms

收稿日期: 2016-09-04 修回日期: 2017-03-27 发布日期: 2018-05-25 期的出版日期: 2017-04-26

ZTFLH:

R734．2

通讯作者: 丁浩

作者简介: 丁浩，男，36岁，张家港市第一人民医院(苏州大学附属张家港医院)心胸外科主治医师。

引用本文:

丁浩，陆亚东，马春平. 避开肋间神经闭合技术在肺癌手术中的应用价值分析[J]. 中国现代手术学杂志, 2017, 21(2): 113-116.
DING Hao. The Application Value of Avoiding Intercostal Nerve Closure Technique in Lung Cancer Surgery. Chinese Journal of Modern Operative Surgery, 2017, 21(2): 113-116.

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[1]	丁浩, 陆亚东, 马春平. 避开肋间神经闭合技术在肺癌手术中的应用价值分析[J]. 中国现代手术学杂志, 2017, 21(2): 113-116.

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