数字化胸腔引流系统在胸腔镜肺切除术后应用的临床价值

Clinical Value of Digital Drainage Device in Patients After Thoracoscopic Lung Resection

目的探讨数字化胸腔引流系统在胸腔镜肺切除术后患者中的临床应用效果。方法回顾性分析2018年6月~2019年3月我科210例肺切除手术的临床资料,根据术后采用引流装置的不同分为观察组(术后采用数字化胸腔引流系统)和对照组(术后采用传统胸腔引流装置)。比较2组术后留置胸腔引流管时间、术后住院时间、术后疼痛程度、术后胸腔并发症发生率、住院费用及装置更换引流瓶时间。结果观察组术后中位带管时间2.33(1.79,2.96)d,明显短于对照组2.81(1.89,3.47)d(Z=-2.383,P=0.017);术后中位住院时间3.54(2.71,4.33)d,明显短于对照组3.78(2.88,4.83)d(Z=-2.569,P=0.010)。术后第3天疼痛数字评分中位数静息状态0(0,1)分,活动状态1(0,2)分,均明显小于对照组0(0,1)分和1(1,2)分(Z=-3.056,P=0.002;Z=-2.653,P=0.008)。观察组术后并发症明显少于对照组[5 vs.14,χ~2=4.142,P=0.042]。2组住院费用无显著性差异[(5.11±1.23)万元vs.(5.01±1.40)万元,t=-0.578,P=0.564]。22名护士分别模拟2种装置更换引流瓶,观察组更换引流瓶时间明显短于传统组[(4.0±0.7)min vs.(11.5±1.7)min,t=19.336,P=0.000]。结论相对于传统胸腔引流装置,数字化胸腔引流系统可以缩短胸腔镜肺切除术后患者带管时间和住院时间,减轻疼痛,降低并发症发生率,并缩短引流瓶更换操作用时,未显著增加住院费用,能给医、护、患均带来收益,值得进一步推广。

Objective To evaluate the effects of digital drainage system in patients after thoracoscopic lung resection.Methods Clinical data of 210 patients who underwent thoracoscopic lung resection in our hospital between June 2018 and March 2019 were retrospectively collected.The patients were divided into two groups according to their post-operative drainage device:observation group(digital drainage system)and control group(traditional drainage device).The chest tube drainage time,postoperative hospital stay,postoperative numeric rating scale(NRS)for pain,postoperative morbidity rate,total cost and operating time of replacing the drainage device of the two groups were compared.Results The median duration of chest tube drainage in the digital drainage device group[2.33(1.79,2.96)d]was shorter than that in the control group[2.81(1.89,3.47)d,Z=-2.383,P=0.017],the median postoperative hospital stay[3.54(2.71,4.33)d]was shorter than the control group[3.78 d(2.88,4.83)d,Z=-2.569,P=0.010]and NRS for pain in resting[0(0,1)point]and activity[1(0,2)point]on the 3 rd post-operative day significantly decreased in the digital drainage device group comparing with the traditional drainage device group[0(0,1)point,Z=-3.056,P=0.002 and 1(1,2)point,Z=-2.653,P=0.008].As for overall post-operative complication rate,the digital drainage device group was lower than the control group(5 vs.14,χ~2=4.142,P=0.042)and no difference was found in the hospital cost[(5.11±1.23)ten thousand yuan vs.(5.01±1.40)ten thousand yuan,t=-0.578,P=0.564]between the two groups.When 22 nurses simulated the operation of replacing the drainage device,the time of replacing the drainage bottle with digital chest drainage system was shorter than that of replacing the drainage bottle with traditional device[(4.0±0.7)min vs.(11.5±1.7)min,t=19.336,P=0.000].Conclusions Compared with the traditional device,digital drainage device shortens chest tube duration and postoperative hospital stay,relieves postoperative pain and decreases postoperative complication.This device also shortens the operating time of changing drainage bottle without increasing the total cost.It can bring benefits to doctors,nurses and patients,which is worthy of further promotion.