新型半密闭式细胸膜腔引流管的研发及实验研究(1)
[摘要] 目的 研發并探讨新型半密闭式细胸膜腔引流管的作用效果。 方法 使用胸膜腔密闭模拟系统模拟穿刺漏气实验，实验组使用新型半密闭式细胸膜腔引流管，对照组使用同管径的猪尾巴管。记录置管过程的漏气量，每组各20次。使用巴马小型猪模拟操作性能和安全性实验，胸腔镜下选定20个观察良好的穿刺部位，每个穿刺部位按照从下向上的顺序依次编号3个置管点，对照组(1号)使用12F猪尾巴管组;实验组(2号)使用A型尖端穿刺引导针的新型细型半密闭式胸膜腔引流管;实验组(3号)使用B型尖端穿刺引导针的新型细型半密闭式胸膜腔引流管。胸腔镜下观察每组引流管置入的操作性能及对肺脏的损伤率，每组各20次。 结果 实验组平均漏气量明显低于对照组，差异有统计学意义(P < 0.05)。三组均能顺利穿刺置管到巴马小型猪胸膜腔内，且实验组(2号)和实验组(3号)引流管置入后壁层胸膜的破口与对照组(1号)的壁层胸膜的破口直径相当。进针深度为10 mm时，实验组的损伤率低于对照组，差异无统计学意义(P > 0.05);进针深度为20 mm时，实验组的损伤率低于对照组，差异有统计学意义(P < 0.05)。 结论 新型半密闭式细胸膜腔引流管具有结构简单、精准提示的特点，可有效降低医源性气胸和内脏损伤的发生风险;同时一步法置管操作简单，安全性高，具有良好的临床应用价值。
[关键词] 胸膜腔;引流管;新型;巴马小型猪;实验研究
[中图分类号] R318.6 [文献标识码] A [文章编号] 1673-7210(2019)09(c)-0024-04
Development and experimental study of a new type of semi-closed fine pleural cavity drainage tube
SHI Weicheng HUANG Xujie PENG Xueling ZHAN Wencai LIU Yong
Department of Cardiothoracic Surgery， Guangdong Provincial Armed Police Corps Hospital， Guangzhou Medical University， Guangdong Province， Guangzhou 510507， China
[Abstract] Objective To research and develop the effect of a new type of semi-closed fine pleural cavity drainage tube. Methods A closed pleural cavity simulation system was used to simulate puncture leakage. Experimental group was treated with new semi-enclosed fine pleural cavity drainage tube， control group was treated with pig-tail drainage tube with the same diameter. The volume of air leakage during the operation of the pleural cavity enclosed was recorded， 20 times for each group. Bama miniature pigs was used to simulate the operational performance and safety experiments. Twenty puncture sites with good observation were selected under thoracoscopy， and each puncture site was numbered 3 catheterization sites from bottom to top. Pig tail drainage tube of 12F was used in control group (No.1)， a new type of semi-closed fine pleural cavity drainage tube with a tip puncture guide needle of type A was used in experimental group (No.2)， a new type of semi-closed fine pleural cavity drainage tube with a tip puncture guide needle of type B was used in experimental group (No.3). The operational performance and the rate of lung injury were observed under thoracoscopy， 20 times for each group. Results The average amount of puncture leakage in the experimental group was significantly lower than that in the control group， and the difference was statistically significant (P < 0.05). All the groups were able to successfully placed into the pleural cavity of bama miniature pig， and the rupture in parietal pleura of experimental group (No.2) and experimental group (No.3) was the same as that of the control group (No.1). When needling at the depth of 10 mm， the rate of injury in the experimental group was lower than that in the control group， the difference was not statistically significant (P > 0.05). When needling at the depth of 20 mm， the rate of injury in the experimental group was lower that in the control group， the difference was statistically significant (P < 0.05). Conclusion The new semi-enclosed fine pleural cavity drainage tube has the advantages of simple structure and accurate prompt， and can effectively reduce the risk of iatrogenic pneumothorax and visceral injury. At the same time， one-step catheterization is simple， safe and has good clinical value., 百拇医药(石伟成 黄旭杰 彭雪凌 詹文材 刘勇)
[关键词] 胸膜腔;引流管;新型;巴马小型猪;实验研究
[中图分类号] R318.6 [文献标识码] A [文章编号] 1673-7210(2019)09(c)-0024-04
Development and experimental study of a new type of semi-closed fine pleural cavity drainage tube
SHI Weicheng HUANG Xujie PENG Xueling ZHAN Wencai LIU Yong
Department of Cardiothoracic Surgery， Guangdong Provincial Armed Police Corps Hospital， Guangzhou Medical University， Guangdong Province， Guangzhou 510507， China
[Abstract] Objective To research and develop the effect of a new type of semi-closed fine pleural cavity drainage tube. Methods A closed pleural cavity simulation system was used to simulate puncture leakage. Experimental group was treated with new semi-enclosed fine pleural cavity drainage tube， control group was treated with pig-tail drainage tube with the same diameter. The volume of air leakage during the operation of the pleural cavity enclosed was recorded， 20 times for each group. Bama miniature pigs was used to simulate the operational performance and safety experiments. Twenty puncture sites with good observation were selected under thoracoscopy， and each puncture site was numbered 3 catheterization sites from bottom to top. Pig tail drainage tube of 12F was used in control group (No.1)， a new type of semi-closed fine pleural cavity drainage tube with a tip puncture guide needle of type A was used in experimental group (No.2)， a new type of semi-closed fine pleural cavity drainage tube with a tip puncture guide needle of type B was used in experimental group (No.3). The operational performance and the rate of lung injury were observed under thoracoscopy， 20 times for each group. Results The average amount of puncture leakage in the experimental group was significantly lower than that in the control group， and the difference was statistically significant (P < 0.05). All the groups were able to successfully placed into the pleural cavity of bama miniature pig， and the rupture in parietal pleura of experimental group (No.2) and experimental group (No.3) was the same as that of the control group (No.1). When needling at the depth of 10 mm， the rate of injury in the experimental group was lower than that in the control group， the difference was not statistically significant (P > 0.05). When needling at the depth of 20 mm， the rate of injury in the experimental group was lower that in the control group， the difference was statistically significant (P < 0.05). Conclusion The new semi-enclosed fine pleural cavity drainage tube has the advantages of simple structure and accurate prompt， and can effectively reduce the risk of iatrogenic pneumothorax and visceral injury. At the same time， one-step catheterization is simple， safe and has good clinical value., 百拇医药(石伟成 黄旭杰 彭雪凌 詹文材 刘勇)