Clinical Application Research On Modified Thoracic Drainage After Pulmonary Lobectomy

Objective:This research aims to study the feasibility and security of early removed traditional chest drainage tube after pulmonary lobectomy, and replaced with different diameter microtubes. Compare the drainage effect, postoperative recovery, the degree of pain and the incidence rate of complications of different schemes, and provide reference for clinical work.Methods:Using randomized controlled research methods, collect 80 cases after pulmonary lobectomy were randomly divided into three groups:single thick tube(diameter 36Fr=11.5mm) was inserted into the thoracic cavity in the traditional management group(group A), a thick tube and a central venous catheter(diameter 16Ga=1.7mm) were inserted into the thoracic cavity in the improved group(group B), and a thick tube and a pigtail catheter(diameter 8Fr=2.8mm) were inserted into the thoracic cavity in the other improved group(group C). Indications of remove thick tube in group A follow the traditional standard(drainage volume less than 100ml/24h, pulmonary reexpansion without persistent leakage, drainage is non bloody, non chylous and non purulent fluid). Removal of thick tube in group B and group C are not affected by drainage volume,and connect the microtubes with a urine bag after extubation. Drainage volume, drainage time, time of first action off the bed, postoperative hospital stay, pain score, and incidence rate of complications in three groups were recorded and compared.Results:There were no significant differences in complications after extubation, postoperative complications, total drainage time, postoperative daily drainage volume or degree of pain in the first day after surgery between three groups of patients(P>0.05). Total drainage amount, time of first action off the bed, postoperative hospital stay, pain score, pain medication doses of the group A was significantly larger than that of the group B and group C(P<0.05).But more drainage tube blockage happens to group B, which resulted in a higher rate of reinsertion.Conclusion:The drainage method of the two improved groups not only significantly reduce the postoperative pain of patients, but also accelerate the recovery time, and shorten the postoperative hospital stay, reduce patient’s mental and financial burden. But in group C is lower than group B drainage tube failure rate, which is based on sufficient drainage, without increasing complications. So pigtail catheter can be safely and effectively used in pulmonary lobectomy,it is worth promoting.