Effects of nitroglycerin-controlled hypotension on thoracic drainage after esophagectomy

doi:10.3877/cma.j.issn.2095-8773.2018.01.07

Abstract

Abstract:

Objective

To observe the effect of nitroglycerin-controlled hypotension on thoracic drainage and chest drainage time after esophageal cancer radical operation.

Methods

The patients who underwent radical surgery for left thoracic esophageal cancer from March 2015 to April 2017 were randomly divided into the experimental group and the control group. In the experimental group (n = 64), controlled hypotensive blood pressure was controlled by a pump of 0.01% nitroglycerin solution within 48 hours after operation. The blood pressure was controlled strictly in the range of 90-100 mmHg / 60-70 mmHg. In the control group (n = 64), no hypotensive nitroglycerin was administered within 48 hours after operation, and the blood pressure fluctuated between 110-148 mmHg / 70-102 mmHg. Preoperative clinical data of two groups were compared, as well as the amount of thoracic drainage and the total amount of thoracic drainage on the 1st, 3rd, 5th, 7th and 9th days after operation, and the time of postoperative drainage of the thoracic drainage tube.

Results

There were no significant differences in the age, gender, lesion, pathological type and TNM staging of the two groups before operation (P>0.05). Postoperative application of nitroglycerin-controlled hypotension can significantly reduce the removal time of thoracic drainage tube [(8.7±1.1)d vs (10.6±1.3 )d, P<0.05], which can significantly reduce the total amount of postoperative drainage[(939±134)ml vs (1 203±146) ml, P<0.01].

Conclusions

The use of nitroglycerin-controlled hypotension after radical resection in the left thoracic esophageal cancer can effectively reduce the total postoperative thoracic drainage, and can shorten the removal time of drainage tubes and hospital stay time.

Key words: Esophageal cancer, Nitroglycerine, Controlled hypotension, Deliberate hypotension

Xiaolei Zhu, Zijiang Zhu, Wenhao Wang, Yao Pang. Effects of nitroglycerin-controlled hypotension on thoracic drainage after esophagectomy[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2018, 05(01): 32-36.

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References 20

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临床资料		试验组(n＝64)	对照组(n＝64)	χ²值	P值
性别		?	?	0.629	0.427
?	男性	44(68.7)	49(76.6)	?	?
?	女性	20(31.3)	15(23.4)	?	?
肿瘤部位		?	?	1.522	0.467
?	胸中段	33(51.6)	36(56.3)	?	?
?	胸下段	21(32.8)	15(23.4)	?	?
?	贲门	10(15.6)	13(20.3)	?	?
病理类型		?	?	0.548	0.459
?	鳞癌	44(68.7)	39(60.9)	?	?
?	腺癌	20(31.3)	25(39.1)	?	?
TNM分期		?	?	0.129	0.719
?	Ⅰ～Ⅱ期	25(39.1)	28(43.8)	?	?
?	Ⅲ期	39(60.9)	36(56.2)	?	?

临床资料		试验组(n＝64)	对照组(n＝64)	χ²值	P值
性别		?	?	0.629	0.427
?	男性	44(68.7)	49(76.6)	?	?
?	女性	20(31.3)	15(23.4)	?	?
肿瘤部位		?	?	1.522	0.467
?	胸中段	33(51.6)	36(56.3)	?	?
?	胸下段	21(32.8)	15(23.4)	?	?
?	贲门	10(15.6)	13(20.3)	?	?
病理类型		?	?	0.548	0.459
?	鳞癌	44(68.7)	39(60.9)	?	?
?	腺癌	20(31.3)	25(39.1)	?	?
TNM分期		?	?	0.129	0.719
?	Ⅰ～Ⅱ期	25(39.1)	28(43.8)	?	?
?	Ⅲ期	39(60.9)	36(56.2)	?	?

指标		试验组(n＝64)	对照组(n＝64)	χ²值	P值
胸腔引流量(ml)		?	?	?	?
?	第1天	289±33	302±36	2.130	0.035
?	第3天	242±38	272±33	4.769	0.01
?	第5天	202±42	254±37	6.003	0.01
?	第7天	184±32	212±37	4.579	0.01
?	第9天	142±22	170±32	5.768	0.01
?	总引流量	939±134	1 203±146	10.657	0.01
带管时间(d)		8.7±1.1	10.6±1.3	8.926	0.01
住院时间(d)		9.5±1.2	11.2±2.4	5.068	0.01

指标		试验组(n＝64)	对照组(n＝64)	χ²值	P值
胸腔引流量(ml)		?	?	?	?
?	第1天	289±33	302±36	2.130	0.035
?	第3天	242±38	272±33	4.769	0.01
?	第5天	202±42	254±37	6.003	0.01
?	第7天	184±32	212±37	4.579	0.01
?	第9天	142±22	170±32	5.768	0.01
?	总引流量	939±134	1 203±146	10.657	0.01
带管时间(d)		8.7±1.1	10.6±1.3	8.926	0.01
住院时间(d)		9.5±1.2	11.2±2.4	5.068	0.01

并发症	试验组(n＝64)	对照组(n＝64)	P值
肺不张	1(1.6)	3(4.7)	0.612
肺部感染	4(6.3)	1(1.6)	0.362
脓胸	1(1.6)	1(1.6)	0.476
乳糜胸	0(0)	1(1.6)	1.000
心律失常	2(3.1)	3(4.7)	1.000
声音嘶哑	1(1.6)	0(0)	1.000
吻合口瘘	0(0)	1(1.6)	1.000

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