目的 探讨经胸壁穿刺持续负压吸引法解决胸腔镜手术烟雾问题的效果。方法 选择2021年3－6月北京世纪坛医院接受单孔胸腔镜肺叶切除术的患者103例,根据患者意愿分为两组,其中A组48例,B组55例。术中应用经胸壁穿刺持续吸引法的患者归为A组,未使用该方法的归为B组。比较两组患者的年龄、性别、体质指数、肿瘤部位、肿瘤直径、TNM分期、手术时间、术中出血量、术中镜头擦拭次数、术后住院时间以及术中手术室PM 2.5。结果 A组手术时间为(105.14±35.27)min,短于B组[(130.15±38.36)min] (P＜0.001);A组术中镜头擦拭次数为 2.43±2.55,明显少于B组(7.33±4.12) (P＜0.001);A组术中出血量为(85.58±33.45)ml, 少于B组[(106.43±34.23)ml] (P＜0.001)。在手术室空气质量改善方面,A组术中PM2.5 浓度为(55.43± 25.12)μg/m3,远小于B组的(654.34±108.76)μg/m3 (P＜0.001);关胸10 min后两组手术的手术室PM 2.5仍然表现出明显的差异 (P＜0.001)。而两组患者的性别、年龄、体质指数、TNM分期以及术后住院时间无统计学差异。结论 经胸壁穿刺持续吸引法操作简单,效果良好,可减少镜头模糊、缩短手术时间、减少术中出血量、减少手术烟雾造成的手术室环境污染。
Abstract
Objective To investigate the effect of continuous negative pressure suction through chest wall in solving the smoke problem in video-assisted thoracic surgery.Methods One hundred and three patients who underwent single-port thoracoscopic lobectomy from March 2021 to June 2021 were divided into two groups according to patients’will (48 in group A and 55 in group B). The patients applied with the smoke extraction method during operation were classified into group A, while those who were not used with the method were classified into group B. The age, gender, body mass index (BMI), resection range, tumor diameter, TNM stage, operation time, blood loss, intraoperative lens wiping times, postoperative length of hospital stay and intraoperative PM 2.5 in operating room of the two groups were compared.Results The operative time in group A was (105.14±35.27) min, which was shorter than that in group B [(130.15±38.36) min, P<0.001]. The number of lens wiping in group A was 2.43±2.55, which was significantly lower than 7.33±4.12 in group B (P<0.001). The blood loss in group A was (85.58±33.45) ml, while the amount in group B was (106.43±34.23)ml. And there were no statistically significant differences in age, gender, BMI, tumor location, TNM stage and postoperative length of hospital stay between the two groups. In terms of the improvement of air quality in the operating room, the concentration of PM2.5 in group A was (55.43±25.12) μg/m3, much lower than that in group B [(654.34±108.76) μg/m3, P<0.001]. After 10 min of chest closure, the operating room PM 2.5 of the two groups still showed significant difference (P<0.001).Conclusions The continuous negative pressure suction through chest is simple and effective, which can effectively shorten the operation time and reduce the fuzzy lens, the amount of intraoperative blood loss and the pollution of operating rooms.
关键词
胸腔镜手术 /
手术烟雾 /
职业健康 /
手术室
Key words
video-assisted thoracic surgery /
surgical smoke /
occupational health /
operating rooms
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