腹腔镜下腹股沟淋巴结清扫术后即刻灌注铜绿假单胞菌注射液预防淋巴漏的对比研究

Immediate postoperative perfusion of Pseudomonas aeruginosa injection in the treatment of lymphatic fistula induced by inguinal lymph node dissection

目的评估行腹腔镜下腹股沟淋巴结清扫术的患者术后即刻灌注铜绿假单胞菌注射液对术后淋巴漏的预防作用。方法将2021年1月至2024年4月就诊于郑州大学第一附属医院的62例行双侧腹腔镜下腹股沟淋巴结清扫术的患者。采用随机抽签的方式分为实验组与对照组,其中实验组33例,对照组29例。其中实验组患者术后即刻给予灌注稀释后的铜绿假单胞菌注射液1 ml,对照组患者给予注射等量的灭菌注射用水。术前统计所有患者的年龄、体重指数(BMI)指数、肿瘤分期、术前白蛋白等相应参数。术后,统计两组患者清扫淋巴结的数量、阳性淋巴结的数量。术后记录患者第1、2、3天淋巴引流液的引流量,并记录患者拔除引流管的时间。计量资料分析使用独立样本t检验,计数资料分析使用卡方检验。结果所有患者均顺利完成实验,顺利出院,无其他明显并发症的产生。实验组术后淋巴结数量为(10.14±2.83)个,对照组为(10.55±2.70)个,实验组阳性淋巴结有17例,对照组有15例,两组比较差异无统计学意义。实验组术后前3 d的引流量分别为:(91.14±29.10)、(71.24±23.96)、(55.00±23.39)ml。对照组前3 d的引流量分别为:(110.69±33.32)、(92.67±28.72)、(73.62±25.09)ml,3 d引流量的比较差异均有统计学意义(t=3.479、4.342、4.462,P<0.01)。实验组患者的平均拔除引流管天数为(4.82±1.50)d,对照组患者平均拔除引流管天数为(5.57±1.54)d,差异有统计学意义(t=2.832,P<0.01)。结论应用铜绿假单胞菌注射液可显著降低患者术后第1、2、3天的引流量,减少拔除引流管的时间,对于腹腔镜下腹股沟淋巴结清扫术术后引起的淋巴漏有一定的预防作用。

ObjectiveTo evaluate the preventive effect of Pseudomonas aeruginosa injection immediately after laparoscopic inguinal lymph node dissection on postoperative lymphatic leakage.MethodsA total of 62 patients who underwent bilateral laparoscopic inguinal lymph node dissection in the First Affiliated Hospital of Zhengzhou University from January 2021 to April 2024 were enrolled.The patients were randomly divided into experimental group(n=33)and control group(n=29).The patients in the experimental group were given diluted Pseudomonas aeruginosa injection(1 ml)immediately after operation,and those in the control group were given the same amount of sterilized water.The corresponding parameters such as age,body mass index(BMI),tumor stage and preoperative albumin were calculated before operation.After operation,the number of dissected lymph nodes and the number of positive lymph nodes in the two groups were counted.The volume of lymph drainage was recorded on the 1st,2nd and 3rd day after operation,and the time of removal of drainage tube was recorded.Independent sample t-test was used for measurement data analysis,and Chi-square test was used for counting data analysis.ResultsAll patients completed the experiment successfully and discharged smoothly without other obvious complications.There was no significant difference in age,BMI,tumor stage and serum albumin between the two groups before operation.The average number of postoperative lymph nodes was 10.14±2.83 in the experimental group and 10.55±2.70 in the control group.There were 17 positive lymph nodes in the experimental group and 15 in the control group.There was no significant difference between the two groups.The drainage volume of the experimental group in the first 3 days after operation was(91.14±29.10),(71.24±23.96),(55.00±23.39)ml,respectively.In the control group,the drainage volume in the first 3 days was(110.69±33.32),(92.67±28.72),(73.62±25.09)ml(t=3.479,4.342,4.462,P<0.01)respectively.The average time of removal of drainage tube was(4.82±1.50)days in the experimental group and(5.57±1.54)days in the control group(t=2.832,P<0.01).ConclusionThe application of Pseudomonas aeruginosa injection can significantly reduce the drainage volume on the 1st,2nd and 3rd day after operation,shorten the time of removal of drainage tube,and prevent lymphatic leakage after laparoscopic inguinal lymph node dissection.