无管化技术应用于胸廓畸形矫治术的初步探讨

Preliminary study on the application of tubeless minimal invasive techniques in thoracic deformity operations

目的探讨无管化(Tubeless)技术应用于胸廓畸形矫治术的安全性及临床疗效。方法对2015年10月1日至2019年8月31日在我院就诊的胸廓畸形患者临床资料做回顾性分析。随机选取59例入选对照组,83例入选Tubeless组。对照组采用气管插管麻醉,留置胸腔引流管及导尿管行胸廓畸形手术治疗。Tubeless组则采用喉罩麻醉,不使用胸腔引流管及导尿管行胸廓畸形手术治疗。所有患者均在全麻下完成胸廓畸形矫治术。其中对照组漏斗胸43例,鸡胸16例;Tubeless组漏斗胸62例,鸡胸21例。结果所有患者均顺利完成手术,Tubeless技术应用于漏斗胸和鸡胸患者,可显著缩短手术时间(P <0.001),减少出血量(P <0.05),缩短术后住院时间(P <0.05)。此外,Tubeless技术可能还有利于减轻患者术后疼痛,减少气道、尿道、胸腔并发症发生,提升术后生存质量。结论在满足Tubeless技术适用条件下,Tubeless技术应用于胸廓畸形矫治术是安全有效的。

Objective To explore the safety and clinical efficacy of Tubeless technique in the correction of thoracic deformity.Methods The clinical data of patients with thoracic deformity admitted to our hospital from October 1,2015 to August 31,2019 were retrospectively analyzed.59 patients were randomly selected to be enrolled in the control group and 83 patients were enrolled in the Tubeless group.Patients in the control group were treated with tracheal intubation,indwelling thoracic drainage tube and catheter for thoracic malformation,while patients in the Tubeless group were treated with laryngeal mask,no thoracic drainage tube and catheter for thoracic malformation.All patients completed the correction of thoracic deformity under general anesthesia.The control group included 43 cases of pectus excavatum,16 cases of pectus carinatum.While the tubeless group included 62 cases of pectus excavatum,21 cases of pectus carinatum.Results All the patients successfully completed the operation.The Tubeless technique was applied to patients with funnel chest and chicken chest,which could significantly shorten the operation time(P<0.001),reduce blood loss(P<0.05),and shorten the postoperative hospital stay(P<0.05).In addition,Tubeless technology may also be beneficial to reduce postoperative pain,reduce the incidence of airway,urethra and chest complications,and improve postoperative quality of life.Conclusion Under the applicable conditions of Tubeless technique,Tubeless technique is safe and effective in the correction of thoracic deformity.