Fleisher A G, Evans K G, Nelems B, Finley R J
Department of Surgery, University of British Columbia, Vancouver General Hospital, Canada.
Ann Thorac Surg. 1990 Jan;49(1):133-4. doi: 10.1016/0003-4975(90)90371-c.
The effectiveness of fibrin glue as a sealant to reduce postoperative air leaks after pulmonary lobectomy was evaluated in 28 consecutive patients between November 1988 and May 1989. A fibrin glue spray was used in 14 patients, and 14 patients served as controls. Assignment of either group was made before thoracotomy. Nine male and 5 female patients with a mean age of 63.8 years were in the fibrin glue experimental group, and 8 male and 6 female patients with a mean age of 59 years, in the control group. An equal number of complete and incomplete fissures were in each group. All fissures were handled in the same way (stapled). Two milliliters of fibrin glue was applied through a double-syringe delivery system and sprayed on the staple line and any cut surface of the inflated lung just before thoracotomy closure. The fibrin glue-treated group had a mean air leak duration of 2.3 +/- 3.7 days, chest tube drains for 6 +/- 4.1 days, and a postoperative hospitalization of 9.8 +/- 3.1 days. The control group had a mean air leak duration of 3.3 +/- 3.3 days (p = 0.94), chest tube drains for 5.9 +/- 3.9 days (p = 0.95), and a postoperative hospitalization of 11.5 +/- 3.9 days (p = 0.21). We conclude that the routine use of a fixed quantity of fibrin glue is not effective in reducing the duration of air leaks, chest tube drainage, or hospitalization after uncomplicated pulmonary lobectomy.
1988年11月至1989年5月期间，对28例连续接受肺叶切除术的患者评估了纤维蛋白胶作为密封剂减少术后漏气的有效性。14例患者使用纤维蛋白胶喷雾，14例患者作为对照。两组的分配在开胸手术前进行。纤维蛋白胶实验组有9例男性和5例女性患者，平均年龄63.8岁；对照组有8例男性和6例女性患者，平均年龄59岁。每组中完全性和不完全性肺裂的数量相等。所有肺裂的处理方式相同（用吻合器处理）。在即将关闭开胸切口前，通过双注射器给药系统应用2毫升纤维蛋白胶，并喷洒在吻合线和膨胀肺的任何切面上。纤维蛋白胶治疗组的平均漏气持续时间为2.3±3.7天，胸腔引流管留置时间为6±4.1天，术后住院时间为9.8±3.1天。对照组的平均漏气持续时间为3.3±3.3天（p = 0.94），胸腔引流管留置时间为5.9±3.9天（p = 0.95），术后住院时间为11.5±3.9天（p = 0.21）。我们得出结论，常规使用固定量的纤维蛋白胶在减少非复杂性肺叶切除术后的漏气持续时间、胸腔引流管引流时间或住院时间方面无效。
