不同切口封闭置管技术减少单孔胸腔镜术后切口漏气渗液的效果比较  

Comparison of Different Incision Healing Drainage Techniques in Reducing Incisional Leakage and Exudation after Single-Hole Thoracoscopic Surgery

作　　者：傅建军[1] 许国安[1] 周亚军[1] 徐靖[1] 邓武昌[1] 朱良炎 殷波 刘彬 FU Jian-jun;XU Guo＇an;ZHOU Ya-j un;XU Jing;DENG Wu-chang;ZHU Liang-yan;YIN Bo;LIU Bin(Department of Cardiothoracic Surgery,the 94t~＇Hospital of the Chinese People ~ s Liberation Army,Nanchang 330002,China)

机构地区：[1]中国人民解放军第九四医院心胸外科,南昌330002

出　　处：《南昌大学学报（医学版）》2018年第4期47-49,84,107,共5页Journal of Nanchang University：Medical Sciences

摘　　要：目的探讨不同切口封闭置管技术在单孔胸腔镜手术后减少切口漏气、渗液的应用效果。方法将170例行单孔胸腔镜下手术患者按入院时间顺序随机分为3组:观察1组56例患者采用皮肤切口与肋间隙切口错位方法;观察2组57例患者采用胸腔引流管与操作肋间隙分离方法;对照组57例采用常规置管方法,即引流管直接经切口肋间引出。比较3组的切口长度、疼痛程度、引流管放置时间、切口渗液发生率与张力性水泡发生率、拔管后切口漏气发生率及术后住院时间等。结果 3组在切口长度、引流管放置时间、切口张力性水泡发生率方面比较差异无统计学意义(P>0.05);对照组拔管后切口漏气发生率、切口渗液发生率及术后住院时间均较观察1、2组显著增加(P<0.05);观察2组术后24h疼痛程度评分较其他2组显著升高(P<0.05)。结论经过改良切口封闭技术,在不增加额外损伤情况下,能有效减少单孔胸腔镜下手术后切口的漏气、渗液发生率。Objective To investigate the efficacies of different incision healing drainage tech niques in reducing incisional leakage and exudation after single hole thoracoscopic surgery.Methods According to the order of admission,170 patients undergoing single hole thoracoscopic sur gery were divided into three groups. Skin incision and intercostal incision dislocation were per formed in observation group 1 （SG patients）, thoracic drainage tube placement and intercostal space separation in observation group 2 （57 patients）,and conventional intercostal tube incision drainage in control group （57 patients）. The length of incision, degree of pain,time of drainage tube placement,incidence of incisional leakage and exudation after extubation, length of postoper ative hospitalization, and incidence of tension blisters were compared among the three groups. Results There were no significant differences in incision length, drainage tube retention time and incisional tension blisters among the three groups （P〈0.05）.Compared with observation groups 1 and 2,the incidence of incisional leakage and exudation after extubation and the length of postoperative hospitalization significantly increased in control group （P〈0.05）.Compared with obser vation group 1 and control group, the 24 hour postoperative pain degree score obviously increased in observation group 2 （P〈0.05）.Conclusion The improved incision sealing technology is not associated with additional injury and can effectively reduce the incidence of incisional leakage and exudation after single hole thoracoscopic surgery.

关 键 词：切口封闭技术 单孔胸腔镜手术 切口漏气 切口 渗液 

分 类 号：R655[医药卫生—外科学]