微创腋下垂直小切口在肺叶切除术中的临床应用

目的探讨保留胸肌的腋下垂直小切口在肺叶切除术中的应用价值。方法将施行肺叶切除术的73例患者,分为腋下垂直小切口组(40例)和传统后外侧切口组(33例),比较两组患者的手术切口长度、手术时间、术中出血量、术后胸管留置时间、术后胸引管引流量、开始离床活动时间、止痛剂使用量、肺功能指标变化、住院天数等。结果与传统后外侧切口相比,微创腋下垂直小切口术后患者肺功能损伤小,离床活动时间、住院天数明显缩短,切口疼痛明显减轻,止痛剂使用量小,患者满意度较高。两组患者手术时间、术中出血量、术后胸管留置时间和术后胸管引流量无差异。结论腋下垂直小切口肺叶切除术对患者创伤小、安全、术后疼痛轻、肺功能保护较好、恢复快。

Clinical application of minimally invasive subaxillary vertical small incision in lobectomy

Objective To investigate the clinical value of the application of muscle-sparing subaxiUaxy vertical small incision in lobectomy. Methods Seventy-three cases of patients were performed with lobectomy through subaxillary vertical small incision （40 cases） or conventional incision （33 cases）. The two groups were compared in terms of incision length, operative time, blood loss, postoperative drainage volume, postoperative drainage tube retention, out-of-bed time, postoperative pain degree, paregoric dosage, change of pulmonary function, and hospital stay. Results Compared with the conventional posterolateral thoracotomy, subaxiUary vertical small incision reduced injury of pulmonary function, out-of-bed time, hospital stay, and application amount of paregoric, and remarkably improved the acute and chronic postoperative pain and patient＇s satisfaction. No difference was observed between two groups in operation time, the intraoperative blood loss, drainage tube retention, postoperative tube retention, or drainage volume. Conclusion Subaxillary vertical small incision for lobectomy is of less trauma, safety, less pain, better protection of lung function, and quick recovery.