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单孔电视辅助胸腔镜手术治疗原发性自发性气胸后第一小时内活动的结果

Outcomes of mobilization in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax.

作者信息

Unaldi Hatice Eryigit

机构信息

Department of Thoracic Surgery, Istinye University, Istanbul, Turkey.

Department of Thoracic Surgery, Medical Park Gebze Hospital, Gebze, Kocaeli, Turkey.

出版信息

Kardiochir Torakochirurgia Pol. 2024 Mar;21(1):19-22. doi: 10.5114/kitp.2024.138497. Epub 2024 Mar 30.

Abstract

INTRODUCTION

Although primary spontaneous pneumothorax is a common disease in young adults, each thoracic surgery department performs different procedures for its management.

AIM

The optimal time of postoperative mobilization is not yet standardized in lung surgery.

MATERIAL AND METHODS

This study included male patients with a primary spontaneous pneumothorax who underwent wedge resection of the upper lobe of the lungs via uniportal video-assisted thoracoscopic surgery. Patients were encouraged to stand up within the first postoperative hour. Mobilization was defined as standing and walking at least 100 m from the bed. If orthostatic hypotension occurred, mobilization was postponed for 30 min. Immediately after surgery, intravenous fluids were discontinued, and patients were instructed to drink water. The analgesic treatment needs, length of hospitalization, drainage, and discharge times were recorded.

RESULTS

A total of 43 patients were operated on by the same surgeon. All operations were ended with uniportal video-assisted thoracoscopic surgery. Wedge resection is most commonly indicated for recurrent ipsilateral pneumothorax. Patients walked 345 (range: 150-510) m on the department corridor following bed rest. Paracetamol (2 g) and dexketoprofen (100 mg) were intravenously administered as postoperative analgesia to 76.7% of patients. Narcotic drugs were not needed.

CONCLUSIONS

Mobilization was recommended in the first hour following uniportal video-assisted thoracoscopic surgery for primary spontaneous pneumothorax.

摘要

引言

尽管原发性自发性气胸在年轻成年人中是一种常见疾病,但每个胸外科对其治疗采用不同的程序。

目的

肺手术中术后活动的最佳时间尚未标准化。

材料与方法

本研究纳入了通过单孔电视辅助胸腔镜手术对原发性自发性气胸患者进行肺上叶楔形切除术的男性患者。鼓励患者在术后第一小时内站立。活动定义为站立并在离床至少100米处行走。如果发生直立性低血压,则将活动推迟30分钟。手术后立即停止静脉输液,并指导患者饮水。记录镇痛治疗需求、住院时间、引流情况及出院时间。

结果

共有43例患者由同一位外科医生进行手术。所有手术均以单孔电视辅助胸腔镜手术结束。楔形切除术最常用于复发性同侧气胸。患者在卧床休息后在科室走廊行走了345(范围:150 - 510)米。76.7%的患者术后静脉注射对乙酰氨基酚(2克)和右酮洛芬(100毫克)作为镇痛治疗,无需使用麻醉药物。

结论

对于原发性自发性气胸,建议在单孔电视辅助胸腔镜手术后第一小时内进行活动。

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