能量器械马蹄铁形段间平面处理方法在肺部结节胸腔镜精准肺段切除术中的应用  

The application of horseshoe-shaped intersegmental plane processing method with energy equipment in thoracoscopic accurate pulmonary nodules segmentectomy

作　　者：汪方清[1] 陈刚[1] 阮卫民 胡卫建[1] 陈胜[1] 李胜平[1] 汪金钱 WANG Fang-qing;CHEN Gang;RUAN Wei-min;HU Wei-jian;CHEN Sheng;LI Sheng-ping;WANG Jin-qian(Ward 1,Department of Thoracic Surgery,Tongling People's Hospital,Tongling,Anhui 244000,China)

机构地区：[1]铜陵市人民医院心胸外科一病区,安徽铜陵244000

出　　处：《中华全科医学》2022年第11期1866-1869,共4页Chinese Journal of General Practice

基　　金：皖南医学院教学医院科研专项项目(JXYY202211);安徽省重点研究与开发计划项目(202104j07020003);铜陵市卫生健康委员会科学研究基金项目(卫科研[2019]1号)。

摘　　要：目的探讨能量器械马蹄铁形段间平面处理方法应用于肺部结节胸腔镜精准肺段切除术的有效性与安全性。方法选择2019年1月—2021年6月因肺部结节在铜陵市人民医院行胸腔镜下肺段切除手术的100例患者,采用随机数字表法分为能量器械马蹄铁形段间平面切开组(观察组)和切缝器段间平面切开组(对照组),各50例,对比分析手术前后相关临床资料。主要观察指标为术后3 d内引流量、术后肺漏气时间、动脉血气和肺功能等。结果2组术中出血量、手术时间、术后3 d内引流量、术后引流管留置时间、术后肺漏气时间、术后住院时间、术后并发症等指标比较差异无统计学意义(均P>0.05);观察组住院费用少于对照组(P<0.001);术后1个月观察组动脉血气和肺功能指标显著优于对照组(均P<0.05),观察组术后PaO_(2)大于对照组,术后PaCO_(2)小于对照组,观察组术后用力肺活量为(2.58±0.43)L,高于对照组的(2.21±0.34)L,观察组术后第1秒用力呼气容积为(2.32±0.39)L,高于对照组的(1.96±0.32)L,差异有统计学意义(均P<0.05)。结论能量器械马蹄铁形段间平面处理方法应用于肺部结节精准肺段切除术,是一种安全、有效、肺膨胀更加良好并能节约高值耗材的方法,值得推广。Objective To explore the effectiveness and safety of the application of horseshoe-shaped intersegmental plane processing method with energy equipment in thoracoscopic accurate pulmonary nodules segmentectomy.Methods Total 100 patients underwent thoracoscopic segmentectomy for the treatment of pulmonary nodules in Tongling People's Hospital from January 2019 to June 2021 were randomly divided into horseshoe-shaped intersegmental plane incision group with energy equipment(observation group)and intersegmental plane incision group with cutting suture device(control group)according to the random digital table method,with 50 cases in each group.The preoperative and postoperative clinical data was compared and analyzed.The main indexes included the drainage volume within 3 days after operation,the time of pulmonary leakage,arterial blood gas and pulmonary function.Results There was no difference in indexes like intraoperative blood loss,operation time,postoperative drainage volume within 3 days,postoperative drainage tube indwelling time,postoperative pulmonary air leakage time,postoperative hospitalization time and postoperative complications between the two groups(all P>0.05).Hospitalization costs in the observation group were significantly less than those in the control group(P<0.001).At 1 month after operation,the arterial blood gas and the pulmonary function of the observation group was significantly better than that of the control group(all P<0.05).The postoperative PaO_(2) in the observation group was higher than that of the control group,the postoperative PaCO_(2) in the observation group was lower than that of the control group,the postoperative forced vital capacity in the observation group[(2.58±0.43)L]was higher than that of the control group[(2.21±0.34)L],and the postoperative forced expiratory volume in one second in the observation group[(2.32±0.39)L]was higher that of the control group[(1.96±0.32)L].The differences were statistically significant(all P<0.05).Conclusion The application of horseshoe-sha

关 键 词：能量器械 马蹄铁形段间平面处理方法 肺结节 肺段切除术 

分 类 号：R655.3[医药卫生—外科学] R734.2[医药卫生—临床医学]