倒刺线缝合胸腔引流管口在胸外科手术患者的应用

Application of suturing chest drainage tube with barbed wire in patients undergoing thoracic surgery

目的探讨倒刺线缝合胸腔引流管口在胸外科手术患者的应用效果。方法行胸腔镜两孔肺病损手术100例患者缝合引流管口时分别采用倒刺线缝合方法内固定胸管(干预组,52例)或采用常规床垫式外固定缝合方法固定胸管(对照组,48例)。干预组在移除胸管后,收紧2条预先留下的倒刺线来关闭引流管口,无需加压包扎和拆线;对照组在移除胸管后,需加压包扎,拔管后7~10 d拆线。评估两组术后VAS疼痛评分、观察者瘢痕评估量表(OSAS)和患者瘢痕评估量表(PSAS)评分,记录住院时间及引流管口相关并发症的发生情况。结果干预组术后VAS疼痛评分、OSAS和PSAS评分均低于对照组(P<0.05);两组术后住院时间及引流管口相关并发症发生率比较差异均无统计学意义(P>0.05)。结论与常规床垫式外固定缝合方法比较,采用倒刺线缝合引流管口固定胸管的方法安全、有效,并能满足患者对引流管口愈合的美观需求。

Objective To observe the application efficacy of suturing the chest drainage tube with barbed wire in the patients undergoing thoracic surgery.Methods A total of 100 patients undergoing two-hole thoracoscopic surgery for pulmonary lesions were assigned into two groups.During operation, the chest drainage tube was sutured with barbed wire in 52 patients(group A) and a conventional mattress type external fixation was used in 48 patients(group B).After removing the chest drainage tube in group A,the two previously left barbed wires were tightened to close the opening drainage tube without pressure dressing or suture removal.After removing the chest drainage tube in group B,the pressure dressing was required, and the suture was removed after 7-10 days.The postoperative VAS pain score, observer scar assessment scale(OSAS) score, and patient scar assessment scale(PSAS) score were evaluated after operation.The hospital stay and drainage tube-related complications were recorded.Results The postoperative VAS pain score, OSAS score and PSAS score in group A were significantly lower than those in group B(P<0.05).There was no statistical difference in the hospital stay and incidence of drainage tube-related complications between the two groups(P>0.05).Conclusion Compared to the conventional mattress type external fixation, suturing chest drainage tube with barbed wire in the patients undergoing thoracic surgery is safe and effective, and can meet the patient’s aesthetic needs for drainage pipe outlet healing.