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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,P<0.05)及48 h(225.4±47.3m LVS 195.5±66.4 mL,P<0.05)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,P>0.05)、住院时间(6.82±2.23天V S 6.53±3.21天,P>0.05)及发生出血(3例V S 2例,P>0.05)、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。
Objective: To investigate the safety of hemostatic drugs in elderly patients after thoracoscopic lobectomy. Methods: A total of 65 elderly patients (≥65 years of age) undergoing thoracoscopic lobectomy were retrospectively analyzed. Twenty-nine patients (no postoperative hemostatic drugs) and 36 patients in the control group (Routine application of hemostatic drugs). The postoperative drainage of thoracic cavity, drainage tube time, length of hospital stay, related adverse reactions and complications were compared between two groups. The safety and reliability of hemostatic drugs in elderly patients after thoracoscopic lobectomy were evaluated . Results: The thoracic drainage volume of the study group was significantly higher than that of the control group after 24 h (310.6 ± 54.6 m LVS 262.3 ± 67.2 mL, P <0.05) and 48 h (225.4 ± 47.3 m LVS 195.5 ± 66.4 mL, P <0.05) (4.23 ± 2.84 days vs. 4.02 ± 3.37 days, P> 0.05), hospital stay (6.82 ± 2.23 days vs 6.53 ± 3.21 days, P> 0.05) and bleeding (3 cases vs 2 cases, P> 0.05) , There was no significant difference in the embolization risk. However, the use of hemostatic drugs increased the risk of drug-related adverse reactions. In the control group, 11 patients developed gastrointestinal discomfort and 1 had headache after treatment with Berehrom in the control group. Conclusion: Thoracoscopic lobectomy in elderly patients, after strict intraoperative occlusion of hemostatic drugs after surgery is safe and reliable.