单向阀瓣临时胸腔封闭装置的组成结构与应用研究

Design and development of a temporary chest closure device with one-way valve and its applied research

目的 设计制备单向阀瓣临时胸腔封闭装置,并验证其对犬开放性胸外伤的现场救治效果.方法 以犬为实验动物,采用数字表法将8只健康成年的雄性比格犬随机分为对照组（4只）和实验组（4只）,建立犬开放性胸外伤模型.对照组以临床常用纱布封闭胸腔,再用胶带加压;实验组以单向阀瓣临时胸腔封闭装置封闭胸腔.观察2组犬的胸腔封闭固定操作时间、胸腔闭式引流术操作时间,实验犬心率、呼吸频率和血氧饱和度的变化、胸腔封闭材料所承受的最大拉力及引流效果.结果 实验组犬胸腔封闭固定操作时间为（0.58±0.14） min,对照组为（1.17 ±0.21） min,2组比较差异有统计学意义（P＜0.01）;实验组犬后续胸腔闭式引流术操作时间为（0.48 ±0.07） min,对照组为（2.20±0.11） min,2组比较差异有统计学意义（P＜0.01）.实验组犬在胸腔封闭固定前后心率、呼吸频率、血氧饱和度的变化与对照组相比差异均有统计学意义（P＜0.01）,2组犬引流术后各时间点胸腔积液积血引流量差异均无统计学意义（P＞0.05）.结论 单向阀瓣临时胸腔封闭装置能快速有效地封闭胸腔,固定效果确切,可为实施有效的胸腔闭式引流术以及后续治疗创造条件,适用于开放性胸外伤患者的一线救治及院前急救.

Objective To design and develop a temporary chest closure device with one-way valve,and also to demonstrate its on-site therapeutic effect on open chest trauma.Methods Eight dogs were randomly divided into the control group （n =4） and the experimental group （n =4）,and the animal model of open chest injury was established by using the dogs.The chest cavity of the dogs in the control group was closed with gauze combined with tapes commonly used in clinical practice,while the chest cavity of the dogs in the experimental group was closed with a temporary chest closure device with one-way valve.Then,observations were made on the manipulation time of chest closure,the manipulation time of closed thoracic drainage,canine heart rate,changes in respiratory rate and arterial oxygen saturation,the maximum tension exerted on the chest closure device,and drainage effect.Results The manipulation time of chest closure for the experimental group was （0.58 ± 0.14） min,while the time for the control group was （1.17 ± 0.21） min.Statistical significance could be seen,when comparisons were made between the groups （P ＜ 0.01）.The manipulation time of subsequent close thoracic drainage for the experimental group was （0.48 ± 0.07） min,while the time for the control group was （2.20 ± 0.11） min.Statistical significance could also be noted,when comparisons were made between them （P ＜ 0.01）.Statistical differences could be noted in changes in heart rate,respiratory frequency and arterial oxygen saturation before and after chest closure for the experimental group,as compared with those for the control group （P ＜ 0.01）.There were no statistical differences in the drainage amount of pleural effusion and hemotocele at all the time points after drainage,when comparisons were made between the groups （P ＞ 0.05）.Conclusions The temporary chest closure device with one-way valve could quickly and effectively close the thoracic cavity,with confirmed therapeutic results.The device could create favorable conditions for effective implementation of closed thoracic drainage and subsequent treatment,which was suitable for frontline treatment and pre-hospital care of patients with open chest trauma.