保留下肺韧带对胸腔镜下肺上叶切除术后持续性咳嗽的影响

目的 探讨肺上叶切除手术中保留下肺韧带是否可以减少术后持续咳嗽的发生。方法 选取2017年6月—2018年4月依纳入标准选取拟行胸腔镜下肺上叶切除手术肺癌患者100例，按手术方式分为保留下肺韧带组（保留组）和松解下肺韧带组（松解组）各50例，其中行左肺上叶切除37例，右肺上叶切除63例。比较2组患者术后肺部残腔率。应用莱斯特咳嗽量表中文版（LCQ-MC）从生理、心理和社会三个维度评价患者术后持续性咳嗽的改善情况。结果 术后2组患者左肺或右肺残腔率比较差异无统计学意义，且均出现了不同程度的咳嗽症状。行左肺手术的患者中，术后生理、心理、社会维度的LCQ评分均较术前加重，但术后2组间LCQ评分差异均无统计学意义（P >0.05）；行右肺手术的患者中，保留组患者术后生理、心理维度的 LCQ 评分均优于松解组，咳嗽情况有所减轻（P <0.05）。结论 保留下肺韧带对左肺上叶切除术后持续性咳嗽的改善无明显影响，但可以减少右肺上叶切除术后持续性咳嗽的发生。

Clinical observation of persistent cough after thoracoscopic lobectomy for preserved inferior pulmonary ligament in video-assisted thoracic surgery

Objective To investigate the effect of preserved inferior pulmonary ligament in video-assisted thoracic surgery (VATS) upper lobectomy on persistent cough. Methods A total of 100 lung cancer patients were selected in this study from June 2017 to April 2018, according to the adopt standardization. All of the patients were divided into two groups:the division group and the preservation group according to the operation mode. The division group included 50 patients (19 left, 31 right), and the preservation group also included 50 patients (18 left, 32 right). Patients in two groups were investigated by Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC). The postoperative dead space ratio was analyzed between two groups. Results There was no significant difference in dead space ratio after surgery between two groups of patient. And different degrees of cough were found in two groups. In patients with left lung operation,the preoperative score of LCQ-MC was significantly higher than postoperative score, but there was no significant difference in postoperative score of LCQ-MC between the two groups (P > 0.05). In patients with right lung operation the postoperative score of LCQ-MC was significantly higher in the preservation group than that of the division group (P < 0.05), and cough were relieved in the preservation group (P < 0.05). Conclusion Preserved inferior pulmonary ligament in VATS right upper lobectomy can reduce the persistent cough after surgery.