摘要
目的通过初步临床应用研究,探讨本课题组自研的新型微创胸腔镜闭式引流系统的安全性及有效性。方法选取2016年1月—2021年12月在同济大学附属同济医院胸外科因气胸或液气胸而实施胸腔闭式引流的患者共120例拟行胸腔闭式引流的患者,采取完全随机方法将患者分为对照组(n=60)和实验组(n=60),对照组为采用传统胸腔闭式引流组,实验组为采用新型胸腔闭式引流系统组。比较两组患者的临床疗效(治疗有效率)、治疗时间(包括手术时间、术后肺复张时间、引流管留置时间及住院时间)、术中及术后疼痛程度(VAS)及并发症发生率。结果两组组患者性别、年龄、病变位置、严重程度等差异均无统计学意义(P>0.05)。实验组与对照组治疗有效率无明显差异(P>0.05)。与对照组相比,实验组患者肺复张时间、引流管留置时间、住院时间差异均无统计学意义(P>0.05),术中和术后疼痛评分均值显著降低(P<0.001);部分术中及术后并发症(引流管周围渗出和伤口愈合不良)有所下降(P<0.05)。结论应用新型胸腔闭式引流系统治疗气胸或液气胸可以显著降低患者疼痛及部分并发症发生率,利于患者术后伤口愈合,可作为传统胸腔闭式引流的改进方案,值得临床推广。
Objective To evaluate the safety and efficacy of a self-developed minimally invasive thoracic closed drainage system.Methods A total of 120 patients,who underwent thoracic closed drainage due to pneumothorax or hydropneumothorax in the Department of Thoracic Surgery of Tongji Hospital of Tongji University from January 2016 to December 2021,were randomly divided into two groups with 60 cases in each group.The control group was treated with traditional closed chest drainage,and the study group was treated with a self-developed closed chest drainage system.The clinical efficacy,operation time,postoperative lung re-expansion time,drainage tube retention time and length of hospital stay,intraoperative and postoperative pain level(VAS)and complication rate were compared between the two groups.Results There were no significant differences in gender,age,lesion location and severity between the two groups(P>0.05).There were no significant differences in treatment effectiveness,lung recruitment time,drainage tube indwelling time,and length of hospital stay between the two groups(P>0.05).Compared with the control group,the mean intraoperative and postoperative pain scores of the study group were significantly lower(P<0.001);and the intraoperative and postoperative complications including exudation around the drainage tube and poor wound healing were significantly lower in the study group than those in the control group(P<0.05).Conclusion The application of the new thoracic closed drainage system can significantly reduce intraoperative and postoperative pain,facilitate postoperative wound healing and decrease the incidence of complications in treatment of pneumothorax or hydropneumothorax,indicating that this system is worthy of clinical promotion.
作者
亚库甫江·亚森
王曦仕
顾绍瑞
黄柏清
王文利
YAKUFUJIANG·Yasen;WANG Xishi;GU Shaorui;HUANG Boqing;WANG Wenli(School of Medicine,Tongji University,Shanghai 200092,China;Department of Cardiothoracic Surgery,Tongji Hospital,School of Medicine,Tongji University,Shanghai 200065,China;Department of Cardiothoracic Surgery,Putuo District Central Hospital,Shanghai 200062,China)
出处
《同济大学学报（医学版）》
2024年第4期529-535,共7页
Journal of Tongji University(Medical Science)
基金
上海市卫生和计划生育委员会科研项目(20184Y0074)
上海市卫生健康委员会卫生行业临床研究专项(20224Y0345)。
关键词
气胸
液气胸
胸腔闭式引流术
并发症
pneumothorax
hydropneumothorax
thoracic closed drainage surgery
complications
