老年患者全胸腔镜肺叶切除术后去止血治疗的安全性研究

目的:探讨全胸腔镜肺叶切除术后老年患者不应用止血药物的安全性。方法:回顾性分析65例成功施行全胸腔镜肺叶切除手术老年患者(年龄≥65周岁),按术后不同治疗方案分为研究组29例(术后未应用任何止血药物)及对照组36例(常规应用止血药物),对比两组患者术后胸腔引流情况、拔除引流管时间、住院时间、相关不良反应及并发症,评价全胸腔镜肺叶切除术后老年患者不应用止血药物的安全可靠性。结果:研究组术后24 h(310.6±54.6 m LVS 262.3±67.2 mL,P0.05)及48 h(225.4±47.3m LVS 195.5±66.4 mL,P0.05)胸腔引流量高于对照组,拔除引流管时间(4.23±2.84天VS 4.02±3.37天,P0.05)、住院时间(6.82±2.23天V S 6.53±3.21天,P0.05)及发生出血(3例V S 2例,P0.05)、栓塞风险均无显著差异,但应用止血药物增加了药物自身相关不良反应的风险,对照组中应用贝瑞凝止血治疗后,11例患者出现了消化道不适反应,1例患者出现头痛。结论:全胸腔镜肺叶切除术后老年患者,经术中严密止血后术后不应用止血药物是安全可靠的。

Clinic Study on the Safety of Non-application of Hemostatic Agents after Thoracoscopic Lobectomy in Senile Patients

Objective:To evaluate the safety and reliability without hemostatic agents after Video-Assisted Thoracic Surgery(VATS) lobectomy in the elderly patients.Methods:65 cases of elderly patients (older than 65 years) with VATS lobectomy resectionwere randomly divided into two groups, the 29 patients in study group were treated without applying any hemostatic drugs and the 36patients in control group were given postoperative hemostatic drugs. The pleural drainage, tube removal time, hospitalization time,related adverse reactions and complications, were detected and compared between two groups.Results:The volume of pleural drainagein postoperative 24 h and 48 h was higher in study group than that of the control group (P<0.05), and the removal time of chest drainage,hospitalization time and occurrence of hemorrhage, embolic risk had no significant difference between two groups (P>0.05), but theapplication of hemostatic agents increased the risk of adverse drug reactions, there were gastrointestinal discomfort in 11 cases andheadache in one patient.Conclusion:Non-application of hemostatic agents in elderly patients after VATS lobectomy is safe and reliable.