多槽硅胶引流导管在微创胸外科的临床应用  

Clinical application of multi-channel silicone drains in minimally invasive thoracic surgery

作　　者：梁宝磊 蔡庆勇[1] 梁贵友[1] 魏豪 石珂 邵长海 徐刚[1] 汤阳[1] 陈安平[1] Bao-lei Liang;Qing-yong Cai;Gui-you Liang;Hao Wei;Ke Shi;Chang-hai Shao;Gang Xu;Yang Tang;An-ping Chen(Department of Thoracic Surgery,Affiliated Hospital of Zunyi Medical College,Zunyi,Guizhou 563000,China)

机构地区：[1]遵义医学院附属医院胸外科,贵州遵义563000

出　　处：《中国现代医学杂志》2018年第24期57-61,共5页China Journal of Modern Medicine

基　　金：贵州科学技术基金(No:黔科合J字[2013]2325号)

摘　　要：目的探讨多槽硅胶引流导管在微创胸外科手术中的可行性,评价术后应用该引流系统的优越性。方法选取2016年1月-2017年9月该院行胸腔镜手术的患者160例,根据术后应用引流管不同,将其分为负压组(应用多槽硅胶引流导管+自带负压硅胶球囊)和对照组(传统胸管+水封瓶),每组各80例。比较两组术后24 h胸腔引流量、总引流量、拔管时间、术后胸穿次数、术后住院时间、术后第1天与第3天疼痛程度(NRS数字分级法)及术后胸腔出现活动性出血引流效果。结果两组总引流量比较,差异无统计学意义(P>0.05);负压组术后24 h胸腔引流量升高、拔管时间缩短、胸穿次数减少、术后住院时间缩短及疼痛评分降低,负压组优于对照组(P<0.05)。负压组2例48 h时、对照组2例24 h时因活动性出血而再次手术止血。结论多槽硅胶引流导管临床应用有一定优势,但因引流槽较细、有活动性出血时易堵塞而形成凝固性血胸,故需把握不同引流装置的指征。Objective To investigate the feasibility of Multi-channel silicone drains in minimally invasive thoracic surgery. Methods Totally 160 patients undergoing video-assisted thoracoscopic surgery from January 2016 to September 2017 were involved in this study. Two types of drainage tube were utilized （n = 80）： Multi-channel silicone drainage plus silica gel negative-pressure suction, and traditional chest tube plus water seal system. First 24-hour drainage volume post-surgery, total volume of drainage, duration of time of tube, number of thoracentesis after surgery, postoperative hospital stay, levels of pain on postoperative day 1 and 2 （Numeric Rating Scale, NRS）, and efficiency of drainage when bleeding were recorded. Results No distinct difference in total volume of drainage was identified between 2 groups （P 〉 0.05）. Patients in negative pressure group experienced significant decrease of duration of tube, number of thoracentesis after surgery, postoperative hospital stay, and levels of pain on postoperative day 1 and 2 and increase of first 24-hour drainage when compared with those in control group （P 〈 0.05）. Two cases in both negative pressure group and control group underwent unexpected surgery due to internal bleeding. Conclusions Multi-channel silicone drainage exerts clinical advantages with certain indications.

关 键 词：多槽硅胶引流导管 负压硅胶引流球 微创胸外科手术 

分 类 号：R608[医药卫生—外科学]