A new abdominal drainage tube fixation method for 3-port laparoscopic cholecystectomy improves patients’postoperative quality of life

Objective Laparoscopic surgery has become a routine general surgery with many advantages,such as alleviating abdominal pain.However,postoperative pain caused by abdominal drainage tubes has attracted little attention from medical staff.The aim of this study was to explore the influence of a new abdominal drainage tube fixation method for 3-port laparoscopic cholecystectomy(LC)on patients’postoperative quality of life.Methods Patients who underwent 3-port LC with abdominal drainage tubes in the Department of Hepatobiliary Surgery of Linyi People’s Hospital from March 1,2023 to October 31,2023 due to gallstones with chronic cholecystitis were selected for this study.The patients were randomly divided into an experimental group and a control group.In the experimental group,the new abdominal drainage tube fixation method was used,while in the control group,the traditional method was used.Afterward,the quality of life of patient in terms of pain,activity,recovery time,and mental health status was evaluated.The exudate around the patient’s drainage tube was collected for bacterial culture and analysis.Results A total of 139 patients were randomly divided into an experimental group(70 patients)and a control group(69 patients).The patients’baseline characteristics were not significantly different.The patients in the experimental group had better outcomes in quality of life,with higher pain scores(24.03±2.37 vs.15.48±2.29,p<0.001)and activity scores(20.57±1.78 vs.14.13±1.43,p<0.001),and a shorter postoperative recovery time(2.36±0.68 d vs.2.96±1.34 d,p<0.001).The same results were shown in linear regression analysis scores of the 2 groups.The positive rate of bacterial culture in the exudate around the patient’s drainage tube in the experimental group was significantly lower than that in the control group(12.9%vs.43.5%,p<0.001);and furthermore,the positive rate of conditional pathogenic bacteria was even lower(7.1%vs.33.3%,p<0.001)in the experimental group than in the control group.Conclusion This new abdominal drainage tube fixation method can effectively promote patient rehabilitation and improve the quality of life for patient following 3-port LC with abdominal drainage tubes.

Application of Grooved Negative Pressure Drainage Tube in Surgical Stabilization of Rib Fractures

Objective: To explore the application value of disposable grooved negative pressure drainage tubes in rib fracture incision and internal fixation. Methods: Seventy-five patients admitted to our Department of Trauma Surgery from June 2022 to April 2024 who underwent rib fracture osteotomy and internal fixation were selected. According to the types of drainage tubes left in the patients after the operation, they were divided into the observation group (35 cases who were left with disposable grooved negative pressure drainage tubes) and the control group (40 cases who were left with closed silicone thoracic drainage tubes). Comparison of chest drainage, pain, postoperative complications, secondary chest penetration rate, drain placement time, hospitalization time, and treatment costs were compared between the two groups. Results: The total postoperative chest drainage volume of the observation group was less than that of the control group (P < 0.05);the degree of pain, the incidence of postoperative complications, and the rate of secondary chest puncture in the observation group were lower than that of the control group three days after the operation (P < 0.05);and the time of drain placement in the observation group was shorter than that of the control group (P < 0.05). Conclusion: The application of disposable grooved negative pressure drainage tubes in rib fracture incision and internal fixation can significantly improve patients’ postoperative pain and discomfort, reduce complications, lower the rate of secondary chest penetration, promote patients’ postoperative recovery, decrease the amount of postoperative chest drainage, and shorten the time of drain placement, which is worthy of clinical promotion and application.

Laparoscopic pancreatic duct incision and stone removal and T-type tube drainage for pancreatic duct stone: A case report and review of literature

To study a more micro-invasive procedure for patients having pancreatic duct stones(PDS).Till now,there has been no report of laparoscopic pancreatic duct incision and stone removal and T-type tube drainage for PDS in the English literature.An 82-year-old man suffered from subxiphoid pain associated with a dilated pancreatic duct(7 mm)containing one stone,but without a mass in the head of the pancreas.Laparoscopic pancreatic duct incision,stone removal,and T-type tube drainage were successfully performed without intraoperative or postoperative complications.An uneventful operation was performed with laparoscopically completed procedures in 160 min.The intraoperative loss of blood was around 50 mL.After patient a discharge on day 11,complete relief from the subxiphoid pain was reported at a follow-up visit 15 mo later.Laparoscopic pancreatic duct incision with stone removal and T-type tube drainage is applicable in carefully selected patients and can be effectively and safely used for the treatment of the abdominal pain of chronic pancreatitis.

Efficacy and Safety of Transanal Tube Drainage for Prevention of Anastomotic Leakage Following Laparoscopic Low Anterior Resection for Rectal Cancers

Introduction: Laparoscopic surgery is widely used for the treatment of colorectal cancer. But anastomotic leakage is one of the most serious complications following laparoscopic low anterior resection (LAR) for rectal cancer. The purpose of this study was to investigate whether transanal drainage tube placement can reduce anastomotic leakage and avoid re-operation after laparoscopic LAR. Methods: Retrospective assessment was performed on 143 patients with rectal cancers who underwent laparoscopic LAR between April 2009 and March 2016. A diverting stoma was not created in all 143 patients. A transanal drainage tube was placed after anastomosis using a double stapling technique, in 90 patients (group TT). In group TT, a 24 Fr. Silicon catheter was inserted into the anus and was placed approximately 20 - 25 cm in the descending colon. Another 53 patients were operated on without a transanal drainage tube (group NTT). Clinicopathological and operative variables, the frequencies of anastomotic leakage and re-operation after leakage were investigated. Results: Between the two groups (Group TT and NTT), age, gender, body mass index, tumor size, Dukes’ stage, the number of Liniar stapler firings for rectal transaction, and the rate of left colic artery preservation were comparable. Intra-operative blood loss and operation time decreased group TT from group NTT (p < 0.05). The frequency of leakage was 2.8% (2/69) in group TT and was 13.2% (7/53) in group NTT. The rate of leakage was significantly lower in group TT (p = 0.03). Furthermore, the re-operation rate for symptomatic anastomotic leakage was 0% (0/2) in group TT, while in contrast it was 28.5% (2/7) in group NTT. The rate of re-operation was lower in group TT than group NTT (p = 0.07) and all cases with symptomatic leakage in group TT were cured by conservative treatment. There was no side effect of transanal drainage tube (perforation or bleeding of the colon, or deviation of the tube) in Group TT. Conclusions: Transanal drainage tube placement prevents anastomotic leakage after laparoscopic LAR. We regard the transnanal drainage tube to be safe and effective without side effect.

Triple tube drainage for “difficult” gastroduodenal perforations:A prospective study

AIMTo prospectively study the outcome of difficult gastroduodenal perforations (GDPs) treated by triple tube drainage (TTD) in order to standardize the procedure.METHODSPatients presenting to a single surgical unit of a tertiary hospital with difficult GDPs (large, unfavourable local and systemic factors) were treated with TTD (gastrostomy, duodenostomy and feeding jejunostomy). Postoperative parameters were observed like time to return of bowel sounds, time to start enteral feeds, time to start oral feeds, daily output of all drains, time to clamping/removal of all drains, time for skin to heal, complications, hospital stay, and, mortality. Descriptive statistics were used.RESULTSBetween December 2013 and April 2015, 20 patients undergoing TTD for GDP were included, with mean age of 44.6 ± 19.8 years and male:female ratio of 17:3. Mean pre-operative APACHE II scores were 10.85 ± 3.55; most GDPs were prepyloric (9/20; 45%) or proximal duodenal (8/20; 40%) and mean size was 1.83 ± 0.59 cm (largest 2.5 cm). Median times of resumption of enteral feeding, removal of gastrostomy, removal of duodenostomy, removal of feeding jejunostomy and oral feeding were 4 d (4-5 IQR), 13 (12-16.5 IQR), 16 (16.25-22.25 IQR), 18 (16.5-24 IQR) and 12 d (10.75-18.5 IQR) respectively. Median hospital stay was 22 d (19-26 IQR) while mortality was 4/20 (20%).CONCLUSIONTTD for difficult GDP is feasible, easy in the emergency, and patients recover in two-three weeks. It obviates the need for technically demanding and riskier procedures.

Novel brachytherapy drainage tube loaded with double 125I strands for hilar cholangiocarcinoma: A case report

BACKGROUND Hilar cholangiocarcinoma(CC)is a common malignant tumor with high malignancy and poor prognosis.Most patients have lost the opportunity to undergo radical surgery when diagnosed.Although palliative drainage or biliary stent placement is a preferable choice,the tumor cannot be controlled.This study aimed to develop a novel brachytherapy drainage tube for low-dose-rate brachytherapy with an effective drainage,thereby prolonging the survival time of patients.CASE SUMMARY A 54-year-old male patient had undergone choledochal stent implantation due to obstructive jaundice.He was admitted to the hospital because of the recurrence of jaundice.Preoperative imaging and pathological biopsy revealed hilar CC(Bismuth-Corlette type IIIa).First,the patient underwent percutaneous transhepatic cholangial drainage and the symptoms of jaundice gradually relieved.To further treat hilar CC and remove the biliary drainage tube as far as possible,the patient chose to use the novel brachytherapy drainage tube after a multi-disciplinary consultation.After 1 mo of brachytherapy,the re-examination revealed that the obstructive lesions disappeared,and the drainage tube was finally removed.During the following 10 mo of follow-up,the patient's hilar CC did not recur.CONCLUSION The novel brachytherapy drainage tube may be a new choice for patients with unresectable hilar CC.

How to secure the connection between thoracostomy tube and drainage system?

BACKGROUND: Thoracostomy tube insertion is one of the common bedside procedures in emergency medicine and many acute specialties. Dislodgement of thoracostomy tube from the connection tube of chest drainage system is an important problem with potential complications such as contamination, infection and pneumothorax. Besides, mere loosening can also lead to malfunction. It is a common practice to tape the connection of the system. This study aimed to evaluate the materials and methods of connection of chest drain system to minimize drainage dislodgement. METHODS: We conducted an experimental study to assess the tightness of the connection with various taping materials and methods. We selected three commonly used adhesive materials(3M^(tm) Transpore^(tm) Medical tape, 3M^(tm) Micropore^(tm) Medical tape, 3M^(tm) Soft Cloth Tape on Liner) and three different methods(cross method, straight method, nylon band) to secure the junction between the thoracostomy tube and the bi-conical adaptor in the drainage system. The measured outcome was the weight causing visible loosening of the junction between thoracotomy tube and the adaptor.RESULTS: For each taping material and taping method, 10 trials were performed. The median weight required to disconnect the junction is 26.22 lb for Transpore^(tm), 31.29 lb for Micropore^(tm) and 32.44 lb for Soft Cloth Tape on Liner. A smaller force was required to disconnect if Transpore^(tm) is used(P<0.001). There was no statistical signifi cant difference between Micropore^(tm) and Soft Cloth Tape on Liner(P=0.98). The median disconnecting force is 32.44 lb for straight taping method, 40.55 lb for cross taping method and 21.15 lb for plastic band. The cross-taping method was the more secure method(P<0.0001 when compared with plastic band)(P=0.033 when compared with straight method).CONCLUSION: Cross-taping is the most secure method among the tested varieties in connecting the thoracostomy tube to the chest drainage system. Transpore^(tm) is not a recommended material for thoracostomy tube taping.

Research on a bifurcation location algorithm of a drainage tube based on 3D medical images

Based on patient computerized tomography data,we segmented a region containing an intracranial hematoma using the threshold method and reconstructed the 3D hematoma model.To improve the efficiency and accuracy of identifying puncture points,a point-cloud search arithmetic method for modified adaptive weighted particle swarm optimization is proposed and used for optimal external axis extraction.According to the characteristics of the multitube drainage tube and the clinical needs of puncture for intracranial hematoma removal,the proposed algorithm can provide an optimal route for a drainage tube for the hematoma,the precise position of the puncture point,and preoperative planning information,which have considerable instructional significance for clinicians.

Metal stent combined with ileus drainage tube for the treatment of delayed rectal perforation: A case report

BACKGROUND Acute iatrogenic colorectal perforation(AICP)is a serious adverse event,and immediate AICP usually requires early endoscopic closure.Immediate surgical repair is required if the perforation is large,the endoscopic closure fails,or the patient's clinical condition deteriorates.In cases of delayed AICP(>4 h),surgical repair or enterostomy is usually performed,but delayed rectal perforation is rare.CASE SUMMARY A 53-year-old male patient underwent endoscopic submucosal dissection(ESD)at a local hospital for the treatment of a laterally spreading tumor of the rectum,and the wound was closed by an endoscopist using a purse-string suture.Unfortunately,the patient then presented with delayed rectal perforation(6 h after ESD).The surgeons at the local hospital attempted to treat the perforation and wound surface using transrectal endoscopic microsurgery(TEM);however,the perforation worsened and became enlarged,multiple injuries to the mucosa around the perforation and partial tearing of the rectal mucosa occurred,and the internal anal sphincter was damaged.As a result,the perforation became more complicated.Due to the increased bleeding,surgical treatment with suturing could not be performed using TEM.Therefore,the patient was sent to our medical center for follow-up treatment.After a multidisciplinary discussion,we believed that the patient should undergo an enterostomy.However,the patient strongly refused this treatment plan.Because the position of the rectal perforation was relatively low and the intestine had been adequately prepared,we attempted to treat the complicated delayed rectal perforation using a self-expanding covered mental stent(SECMS)in combination with a transanal ileus drainage tube(TIDT).CONCLUSION For patients with complicated delayed perforation in the lower rectum and adequate intestinal preparation,a SECMS combined with a TIDT can be used and may result in very good outcomes.

Decompression of Malignant Large-bowel Obstruction with a Self-expanding Metallic Stent or Transanal Drainage Tube

Objective To compare the outcomes after self-expanding metallic stent (SEMS) or transanal drainage tube (TDT) placement in patients with malignant large-bowel obstruction (MLBO). Methods Seventy-three patients with MLBO from the clinical unit underwent SEMS (n = 51) or TDT (n = 22) placement from 2012 to 2017. The success rates of placement, clinical outcomes after decompression, complications, the time to resuming enteral nutrition (EN), Karnofsky performance status (KPS) scoring and the following-up therapeutic options were investigated. Results Technical success were achieved in 100% of patients in both groups. The clinical success rates were 98.0%(50/51) for SEMS and 95.5%(21/22) for TDT. No perforation was found in any group, while 3.9%(2/51) in the SEMS and 18.2%(4/22) in TDT group experienced displacement (P = 0.26). It took 2.1 IQR (0~2) days and 3 IQR (2~5) days to resume EN in the SEMS and TDT groups, respectively (P < 0.001). The KPS scores were significantly higher in patients implanted with SEMS (70, IQR 50~80) than in those with TDT (35, IQR 30~50)(P < 0.001). In the SEMS group, 37.3%(19/51) of patients underwent stenting as a bridge to surgery, 9.8%(5/51) for chemotherapy only and 52.9%(27/51) for palliation, while 40.9%(9/22), 0 and 59.1%(13/22) underwent placement for these reasons in the TDT group, respectively. The majority (6/9) of the patients who underwent TDT placement as a bridge to surgery required stoma creation, while only 31.6%(6/19) of those in the SEMS group needed a stoma (P = 0.080). In addition, anastomotic leakage was only found in the TDT group (2/9)(P = 0.10). Conclusion Both SEMS and TDT placement could provide clinical relief for MLBO. However, SEMS placement is associated with earlier EN, fewer complications, and benefits for the postoperative quality-of-life.

Factors Inducing Drainage Tube Complications After Hepatobiliary Surgery

Objective:To explore the main factors of drainage tube complications after hepatobiliary surgery.Methods:From November 2019 to October 2021,103 patients with drainage tube complications after hepatobiliary surgery in Changshu No.2 People’s Hospital were selected as subjects for this study;the factors of postoperative drainage tube complications were analyzed by retrospective analysis.Results:The complications of drainage tubes include cavity organ damage,sliding of drainage tube into the abdominal cavity,broken drainage tube,blocked drainage tube,bleeding in drainage tube,bleeding from the mouth of drainage tube,abdominal cavity infection caused by drainage tube,and intestinal obstruction caused by drainage tube compression;the number of cases were 9,8,12,21,18,17,8,and 10,accounting for 8.74%,7.77%,11.65%,20.39%,17.48%,16.50%,7.77%,and 9.70%,respectively;the causes of these complications include early and late removal of drainage tube,improper positioning,color of drainage fluid,drainage tube falling out or self-removal,and so on.Conclusion:After hepatobiliary surgery,although the complications caused by drainage tubes have certain relationship with the indwelling time and surgery,the most critical is related to postoperative nursing care;therefore,it is necessary to observe the condition of the drainage tube and draining fluid after surgery,including the color of the fluid,its flow rate,and whether the drainage tube leaks or falls out;after surgery,patients should be encouraged to cooperate with the medical staffs,and family members should be reminded to pay attention to the observation of patients and informed about matters needing attention,so as to reduce the incidence of drainage tube complications after hepatobiliary surgery.

Comparison Study of Different Drainage Tube Diameters with Negative Pressure Suction after Valve Replacement Surgery

Objective: This study aims to compare the effects of different drainage tube diameters (22F vs. 26F) combined with negative pressure suction on patients after valve replacement surgery, including postoperative indicators and complications. Methods: A total of 104 patients undergoing valve replacement surgery were included and divided into a 22F group (45 patients) and a 26F group (59 patients). The basic characteristics, postoperative ICU stay duration, drainage duration, postoperative complications, and pain scores were compared between the two groups. All data were analyzed using SPSS statistical software, with p Results: There were no significant differences between the two groups in terms of age, sex, and underlying diseases. The ICU stay duration and drainage duration showed no significant differences (p > 0.05). The total drainage volume in the 22F group was significantly lower than that in the 26F group (225 vs. 380 ml, p = 0.035), and the pain scores on the third postoperative day were also significantly lower in the 22F group (p Conclusion: Compared to the 26F group, patients in the 22F group exhibited less postoperative drainage volume and lower pain scores, suggesting that the 22F drainage tube may have better clinical outcomes after valve replacement surgery.

医疗失效模式及效应分析在腹部引流管管周潮湿相关性皮肤损伤管理中的应用

目的探讨医疗失效模式与效应分析(health care failure mode and effect analysis,HFMEA)在腹部引流管管周潮湿相关性皮肤损伤(moisture associated skin damage,MASD)中的应用效果。方法采用方便抽样法,选取我院2023年1-7月外科病房术后放置腹部引流管的患者360例。其中1-3月应用前的180例患者为对照组,4-7月应用后的180例患者为观察组。根据HFMEA质量改进方法,成立外科腹部引流管管周潮湿相关性皮肤损伤管理流程改进小组,并对其流程进行失效模式及潜在的原因分析,比较改进前后引流管管周MASD的发生率,引流管管周MASDⅢ+Ⅳ度的发生占比以及主要失效模式风险指数(risk priority number,RPN)值。结果实施医疗失效模式与效应分析管理后,引流管管周MASD的发生率下降(P<0.05),Ⅲ-Ⅳ度引流管管周MASD的发生减少(P<0.05),14项RPN比较差异均有统计学意义(P<0.05)。结论HFMEA管理模式有利于规范引流管管周MADS管理流程,规避护理风险。

LCBDE术中一期缝合与T管引流的术后胆漏发生率比较

目的比较腹腔镜胆总管探查术中(LCBDE)行一期缝合和T管引流的术后胆漏发生率,并分析术后胆漏的危险因素。方法回顾性分析2015年1月至2022年11月于温州医科大学附属第一医院行LCBDE的患者资料,分为一期缝合组和T管引流组,采用Logistic多因素回归分别分析两组发生胆漏的危险因素。对两组中有肝内结石、上段胆总管结石、最大结石直径、体温最高值和中性粒细胞百分比5项指标进行倾向性评分匹配(PSM)后,比较两组胆漏发生率。结果共纳入患者1052例,其中143例患者发生术后胆漏,发生率为13.5%。Logistic多因素回归分析显示年龄>60岁为一期缝合组(n=506)胆漏的危险因素(OR=2.242,95%CI 1.300-4.038,P=0.005),主刀医师实施LCBDE少于10例为T管引流组(n=546)胆漏的危险因素(OR=3.525,95%CI 1.469-7.996,P=0.003)。经PSM成功匹配383对患者,一期缝合组胆漏发生率较T管引流组高[15.1%(58/383)vs 9.9%(38/383),P=0.029]。结论患者年龄>60岁是行LCBDE术中一期缝合后发生胆漏的独立危险因素,医师经验不足(主刀医师实施LCBDE少于10例)是行留置T管后发生胆漏的独立危险因素。相较于一期缝合,留置T管引流可以降低LCBDE术后胆漏的发生率。

LCBDE术并一期缝合与并T形管引流治疗老年胆总管结石的临床研究

目的 分析老年胆总管结石患者应用经腹腔镜胆总管切开探查并取石术(Laparoscopic Common Bile Duct Ex-ploration,LCBDE)并一期缝合与并T形管引流治疗取得的疗效。方法 采用目的抽样法选取2020年2月—2023年12月安徽省池州市人民医院78例老年胆总管结石患者为研究对象(均行LCBDE术治疗),按照治疗方法不同分为两组,每组39例,分别提供一期缝合治疗(观察组)和T形管引流治疗(对照组),比较两组手术时间、引流时间、住院时间、出血量、并发症发生率。结果 两组引流时间比较,差异无统计学意义(P>0.05)。观察组手术时间、住院时间短于对照组,出血量少于对照组,差异有统计学意义(P均<0.05)。观察组水电解质紊乱率(2.56%)、胆道出血率为(0)、残余结石率(2.56%)、胆道感染率为(0)低于对照组,差异有统计学意义(χ^(2)=3.924、5.343、3.924、5.343,P均<0.05)。结论 老年胆总管结石应用LCBDE术并一期缝合的效果更佳,相比于T形管引流治疗,可以更好地改善患者预后,应用价值高。

鼻胆管固定的研究进展

鼻胆管引流术是在内镜下逆行胰胆管造影术(ERCP)基础上进行胆道引流,达到减压、退黄、消除炎症的治疗技术。做好鼻胆管护理,创新固定方法,对保持有效引流至关重要。由于鼻胆管较长,材质硬,留置鼻胆管造成患者诸多不适,临床上发生非计划性拔管偶有发生,此外,胆汁黏稠,容易管路堵塞、引流不畅,影响术后病情的转归。对于鼻胆管的材质、固定方法进行综述,以期为临床提供参考。

胸腔内注射凝血酶、引流管悬吊联合治疗难治性气胸的疗效

目的探讨胸腔内注射凝血酶、引流管悬吊联合治疗难治性气胸的临床疗效,并观察该治疗方案对患者漏口闭合时间、发热发生率的影响。方法前瞻性选取2020年6月至2022年6月医院106例难治性气胸患者,依据随机数字表法将其分为对照组53例与研究组53例,对照组采用胸腔内注射凝血酶+常规胸腔闭式引流治疗,研究组采用胸腔内注射凝血酶+引流管悬吊治疗,观察2组临床疗效、留管时间、漏口闭合时间、住院时间、并发症(发热、胸膜粘连、纵隔气肿),对比2组治疗前、后肺功能指标[肺活量(VC)、残气量(RV)、肺一氧化碳弥散量(DLCO)、肺总量(TLC)]、血气分析指标[动脉血氧分压(PaO_(2))、二氧化碳分压(PCO_(2))、氧合指数(PaO_(2)/FiO_(2))、血氧饱和度(SaO_(2))]、6 min行走试验(6MWT)、Borg呼吸困难指数。结果治疗后,研究组总有效率高于对照组(P<0.05);研究组留管时间、漏口闭合时间、住院时间短于对照组(P<0.05);研究组并发症少于对照组(P<0.05);治疗后,2组VC、RV、DLCO、TLC高于治疗前,且与对照组相比,研究组更高(P<0.05);治疗后,2组PaO_(2)、PaO_(2)/FiO_(2)、SaO_(2)高于治疗前,PaCO_(2)、Borg呼吸困难指数低于治疗前,6MWT长于治疗前,且与对照组相比,研究组变化幅度更大(P<0.05)。结论胸腔内注射凝血酶联合引流管悬吊治疗难治性气胸效果显著,可改善患者肺功能指标、血气指标,减轻呼吸困难症状,提高运动耐量,缩短恢复时间,且不会增加并发症。

胸腔内注射凝血酶联合引流管悬吊治疗难治性气胸的临床疗效

目的观察胸腔内注射凝血酶联合引流管悬吊治疗难治性气胸的临床疗效。方法纳入2022年5月—2023年5月医院接受胸腔内注射凝血酶联合引流管悬吊治疗的60例难治性气胸患者,作为观察组,并纳入同时期医院接受持续胸腔闭式引流,辅助以持续负压吸引常规内科治疗的52例难治性气胸患者,作为对照组;治疗3周后比较两组临床疗效、临床指标(炎症发生率、肺部感染情况、肺功能障碍发生情况、刺激性咳嗽)、免疫功能指标[成熟T淋巴细胞(CD_(3)^(+))、指诱导性T细胞/辅助性T细胞(CD_(4)^(+))、抑制性T细胞/细胞毒性T细胞(CD_(8)^(+))]以及药物不良反应的发生情况。结果治疗3周后,观察组和对照组总有效率分别为96.67%(58/60)和82.69%(43/52),差异有统计学意义(P<0.05)。治疗3周后,观察组和对照组的临床指标(炎症发生率、肺部感染情况、肺功能障碍发生情况、刺激性咳嗽)有所好转,且观察组优于对照组,差异具有统计学意义(P<0.05)。治疗3周后,观察组和的对照组的CD_(3)^(+)分别为(1 890.39±172.45)、(860.11±93.64)μL;观察组和的对照组的CD_(4)^(+)分别为(900.63±94.13)、(478.17±50.74)μL;观察组和的对照组的CD_(8)^(+)分别为(800.41±84.35)、(330.42±30.86)μL,差异具有统计学意义(P<0.05)。对照组和观察组治疗期间均无不良反应,差异无统计学意义(P>0.05)。结论胸腔内注射凝血酶联合引流管悬吊治疗难治性气胸有良好的临床疗效,且治愈率较高。

胸腔镜肺楔形术后自制免缝胸管引流对切口疼痛影响的观察

目的探讨在腔镜肺楔形手术中应用自制免缝胸管代替传统胸管引流对切口疼痛的影响及优势。方法选取2021年1月—2023年4月在本院就诊并行胸腔镜肺楔形切除手术的65例患者,采用随机数字表法分为观察组(34例)和对照组(31例)。其中,观察组患者使用自制免缝胸管行胸腔引流,对照组使用传统胸管进行引流。比较两组的疼痛程度、并发症发生率和生活质量评分。结果观察组术后1d、2d、3d的VAS疼痛评分均低于对照组,组间差异有统计学意义(P<0.05)。观察组并发症发生率低于对照组,组间差异有统计学意义(P<0.05)。观察组患者总体生活质量评分较对照组存在明显优势,差异有统计学意义(P<0.05)。结论自制免缝胸管相较于传统胸管,在缓解患者术后疼痛、降低并发症发生率以及提升患者整体生活质量方面,展现出了更为显著的优势,值得临床推广应用。

带针胸管胸腔闭式引流术联合高频机械通气治疗新生儿气胸的临床效果

目的:分析带针胸管胸腔闭式引流术联合高频机械通气(HFOV)治疗新生儿气胸的临床效果及安全性。方法:选取2022年1月—2023年12月昆明市第一人民医院收治的新生儿气胸患儿62例为研究对象,随机分为对照组和观察组,各31例。对照组实施传统胸腔闭式引流术联合常频机械通气治疗,观察组实施带针胸管胸腔闭式引流术联合HFOV治疗。比较两组治疗效果、血气分析指标、治疗指标及并发症发生率。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P=0.006);治疗12 h后,两组动脉血氧分压、动脉血二氧化碳分压、氧合指数、吸入氧浓度优于治疗前,观察组优于对照组,差异有统计学意义(P<0.05);观察组操作时间、起效时间、呼吸机参数下调时间、胸部X线恢复正常时间、住院时间短于对照组,伤口直径小于对照组,差异有统计学意义(P<0.05);观察组并发症发生率低于对照组,差异有统计学意义(P=0.005)。结论:带针胸管胸腔闭式引流术联合HFOV治疗新生儿气胸的效果显著,可改善新生儿血气分析指标,缩短病情转归时间,安全性较高。