吴小凤 黄晓明 詹芳 肖欢

[摘要]目的 探討一次性输液管排烟雾法在腹腔镜肠癌根治术中的临床应用效果。方法 选取2016年3月～2018年11月我院择期行腹腔镜肠癌根治术的50例患者为研究对象，采用随机数字表法将其分为对照组和观察组，每组各25例。两组均行常规腹腔镜肠癌根治术治疗，对照组术中采取传统排烟雾法，观察组术中采取一次性输液管排烟雾法。比较两组的手术情况、术中图像清晰度、术中CO2浓度、主刀医师满意度及手术前后手术室空气洁净度。结果 观察组的手术总时间短于对照组，术中出血量少于对照组，差异均有统计学意义（P<0.05）;观察组术中图像清晰度评分和主刀医师满意度评分高于对照组，术中CO2浓度低于对照组，差异均有统计学意义（P<0.05）;观察组术后直径0.3 、0.5、1.0、3.0、5.0 μm尘埃数量低于对照组，差异均有统计学意义（P<0.05）。结论 一次性输液管排烟雾法能保障手术连贯性，缩短手术时间，提高图像清晰度和手术室空气洁净度，值得临床推荐。

[关键词]腔镜手术;一次性输液管排烟雾法;图像清晰度;空气洁净度

[中图分类号] R472          [文献标识码] A          [文章编号] 1674-4721（2020）7（a）-0224-04

Application of disposable infusion tube exhaust smoke method in endoscopic surgery

WU Xiao-feng   HUANG Xiao-ming   ZHAN Fang   XIAO Huan

Operating Room， Pingxiang Mining Group General Hospital， Jiangxi Province， Pingxiang   337000， China

[Abstract] Objective To explore the clinical application effect of one-time infusion tube smoke exhaust method in endoscopic surgery. Methods From March 2016 to November 2018， 50 patients who were scheduled to undergo laparoscopic surgery in our hospital were selected as the study objects. They were divided into control group and observation group by random number table method， 25 cases in each group. Patients in both groups were treated with conventional laparoscopic radical surgery for colorectal cancer， while patients in the control group were treated with traditional smoke exhaust method， while patients in the observation group were treated with one-off infusion tube smoke exhaust method. The operation condition， image definition， CO2 concentration， surgeon satisfaction and air cleanliness before and after operation were compared between the two groups. Results The total time of operation in the observation group was shorter than that in the control group， and the amount of bleeding was less than that in the control group， the differences were statistically significant （P<0.05）. The scores of intraoperative image definition and surgeon satisfaction in the observation group were higher than those in the control group， the intraoperative CO2 concentration was lower than that of the control group， the differences were statistically significant （P<0.05）. The number of dust particles with diameter of 0.3， 0.5， 1.0， 3.0 and 5.0 μm in the observation group were lower than those of the control group， the differences were statistically significant （P<0.05）. Conclusion The method of one-time infusion pipe exhaust smoke can ensure the continuity of operation， shorten the operation time， improve the image clarity and the air cleanliness of the operating room， which is worthy of clinical recommendation.

[Key words] Endoscopic surgery; Disposable infusion tube exhaust smoke method; Image clarity; Air cleanliness

随着微创技术的发展，腔镜技术以切口小、痛苦少、术后瘢痕小、恢复快等优点，受到临床医师和患者的认可和选择。但研究显示，腹腔镜术中使用电外科设备分离切割组织和凝固止血，在治疗中，产生大量烟雾，易造成镜面雾化，导致手术视野模糊，增加手术难度及术中出血风险，延长手术时间及麻醉时间[1-2]。传统排烟雾方式需频繁中断手术，不仅效率低，且增加手术风险和手术室医护人员职业暴露危险[3-4]。临床需要开展一种更有效干预方式，以减少排雾对手术的影响，而提高临床治疗效果，获得更满意的预后。本研究对上述情况结合多年工作经验尝试使用一次性输液管排烟雾法获得满意效果，现报道如下。……