从初级自发性肺胸部排水管理的短胸部排水管理的教训
Atsushi Kagimoto1, Atsushi Kamigaichi1, Masayuki Ishida1
1Department of General Thoracic Surgery, National Hospital Organization, Kure Medical Center and Chugoku Cancer Center, 3-1, Aoyama-Cho, Kure, Hiroshima, 737-0023, Japan.
General thoracic and cardiovascular surgery
|May 13, 2024
概括
在视频辅助胸部手术 (VATS) 中缩短流,用于初级自发性肺胸 (PSP) 的切术,显著减少了术后疼痛和止痛药的需求. 这种优化改善了患者的康复和整体的外科结果.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术创新 在外科创新.
- 疼痛管理 疼痛管理
背景情况:
- 视频辅助胸部手术 (VATS) 切口术是初级自发性肺胸 (PSP) 的标准.
- 胸管安置后的VATS子弹切除术可能会导致严重的术后疼痛.
- 优化胸管管理对于患者的舒适和康复至关重要.
研究的目的:
- 为了研究缩短排水对术后疼痛的影响.
- 为了比较接受标准长度与缩短胸部排水的患者在PSP的VATS弹道切除术后的结果.
- 确定在胸外科手术中减少与胸管相关的疼痛的策略.
主要方法:
- 一项对30岁以下患者进行的比较研究,这些患者接受了PSP的VATS丸切除术.
- 组L:标准胸内长度的排水管,在顶部以循环方式放置.
- 组S: 缩短 (大约. 10厘米) 的排水管向顶部放置.
- 使用数值评分表 (NRS) 评估疼痛;术后结果进行比较.
主要成果:
- 在排水前,S组的NRS疼痛评分显著降低 (2.1比4.4,p=0.001).
- 由于疼痛,S组没有患者需要提前清除排水,而L组有4名患者 (p=0.017).
- 与L组相比,S组的患者需要额外的止痛药的患者较少 (p=0.003).
结论:
- 缩短胸内排水的长度可以有效地减少PSP的VATS弹道切除术后的疼痛.
- 这种技术提供了一种简单而有影响力的方法,可以改善术后疼痛管理.
- 这些发现支持采用缩短的排水管,以优化整体胸部外科手术的术后护理.
相关概念视频
Pneumothorax-II
141
Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Clinical Manifestations:
141
Pneumothorax-I
200
A pneumothorax is a condition where air builds up in the space between the lung and the chest wall, causing the lung to collapse. This condition arises when air enters the space between the parietal and visceral pleura, disrupting the negative pressure essential for lung inflation. This can lead to a partial or complete collapse of the lung.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
Pneumothorax can be even further classified as spontaneous, traumatic, and tension pneumothorax.
200
Endoscopic Studies II: Thoracocentesis
252
Thoracentesis(Thoracocentesis), commonly known as pleural tap, is a medical procedure where a 22 gauge needle is inserted into the pleural space, the area between the lung and chest wall. This procedure is commonly performed to diagnose or treat various respiratory disorders.
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...
252
Pneumonia V: Nursing management and Prevention
2.0K
Nursing management of pneumonia involves promoting airway patency, facilitating rest and conserving energy, encouraging fluid intake, maintaining nutrition, and educating patients.
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
The nurse must practice strict medical asepsis and adhere to infection control guidelines to minimize healthcare-associated infections.
Enhance airway patency
Position the patient correctly to facilitate drainage of the affected lung segments. Manual or mechanical percussion and vibration can also be employed....
2.0K
Esophageal Perforation-II: Clinical Manifestations and Management
56
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
56
Oxygen Delivering System II: Venturi Mask and Transtracheal Oxygen
537
Oxygen therapy is a pivotal aspect of medical care, particularly for patients with respiratory ailments. Two prominent oxygen-delivering systems include the Venturi mask and the transtracheal oxygen catheter.
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
Venturi Mask
The Venturi mask, named after the Venturi effect, is designed to deliver precise oxygen concentrations. It consists of a large tube with an oxygen inlet that narrows down, causing a pressure drop that pulls air in through adjustable side ports. The mask is a lightweight,...
537


