胸腔镜肺叶切除患者术后引流液性质动态变化研究#br#

【摘要】目的通过分析胸腔镜肺叶切除术患者术后胸腔引流液性质的动态变化趋势探究早期安全拔除胸腔引流管时机。方法选取2021年1月1日至2021年12月31日在河北北方学院附属第一医院胸心血管外科行胸腔镜肺叶切除患者43例,收集并观察分析术后1周胸腔引流液量、胸水常规、胸水生化等指标变化趋势。结果术后1周胸腔引流液量呈逐渐下降趋势,前4天下降速度较快,后3天下降趋势较缓;胸水常规在术后第4天由中性粒细胞占优转变为淋巴细胞占优;胸水生化中蛋白浓度和腺苷脱氨酶浓度在术后第4天由下降趋势转为开始上升趋势。结论胸腔镜肺叶切除术患者胸膜腔在术后前3天处于急性炎性反应阶段,在术后第4天前后过渡到免疫反应阶段,胸腔引流液性质的转变较引流液量变化更具有生理意义,此时拔出胸腔引流管是安全可行的。

Dynamics and Clinical Significance of Thoracic Drainage Fluid Properties after Thoracoscopic Lobectomy

Objective To explore when to remove chest tube early and safely by analyzing the dynamic changes of thoracic drainage fluid properties after thoracoscopic lobectomy. Methods 43 patients who underwent thoracoscopic lobectomy were selected into group from January 1st, 2021 to December 30th, 2021. The dynamics of thoracic drainage fluid volume, thoracic drainage fluid routine, thoracic drainage fluid biochemistry and other characteristics in the postoperative period (one week after operation) were collected, observed and analyzed. Results One week after operation, the amount of thoracic drainage fluid showed a gradual downward trend, with a rapid decline in the first four days and a slow decline in the last three days; thoracic drainage fluid routine changed from mononuclear cell predominance to polymorphonuclear cell predominance on the fourth day after operation; The protein concentration and adenosine deaminase concentration in thoracic drainage fluid biochemistry began to rise gradually on the fourth day after operation. Conclusion The pleural cavity of patients who underwent thoracoscopic lobectomy was in the stage of acute inflammatory reaction in the first three days after operation, and transitioned to the stage of immune reaction around the fourth day after operation. The change in the properties of the pleural drainage fluid is more physiologically significant than the change in the amount of drainage fluid. At this time, it is safe and feasible to remove chest tube.