中国胸心血管外科临床杂志

中国胸心血管外科临床杂志

胸腔镜肺叶切除术器械包需要优化吗?

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目的 探索优化的器械包能否满足胸腔镜解剖性肺切除术的需要及其临床优势。 方法 分析 2016 年 10 月至 2017 年 1 月四川大学华西医院胸外科连续 200 例行肺叶或肺段切除术的肺癌患者的临床资料,其中男 78 例、女 122 例,年龄56.8(24~83)岁。按器械包不同分为常规组和改良组,每组各 100 例,观察两组手术总时间、出血量、器械清点时间等。 结果 改良组与常规组平均肺叶切除时间[(117.62±42.52)min vs.(120.48±40.62)ml,P=0.112]和术中出血量[(53.14±50.69)min vs.(56.10±49.87)ml,P=0.231]差异均无统计学意义。常规组器械使用率(58.02%±2.39%)显著低于改良组(94.00%±1.48%,P=0.014)。常规组器械清点时间、安装时间和清洗时间[(112.00±26.00)s(70.00±15.00)s(1 010.00±130.00)s]均显著长于改良组[(65.00±23.00)s,(20.00±4.00)s,(665.00±69.00)s,P=0.028,P=0.011,P=0.039];差异有统计学意义。常规组特殊器械包器械费用显著高于改良组[(17 7574.00±14 438.00)元 vs.(13 2027.00±10 311.00)元,P=0.032]。 结论 胸腔镜改良器械包提高器械使用率和工作效率,且不影响肺叶切除时间及出血量。

Objective To evaluate the advantages about video-assisted thoracoscopic surgery (VATS) lobectomy with optimized management of surgical instruments package. Methods A total of 200 patients with lung cancer were enrolled, which included 78 males and 122 females, aged 24-83 years at median age of 56.8 years. All of them were divided into 2 groups including a routine group (n=100) and an optimized management of surgical instruments group (n=100). The total operation time, bleeding, instrument weights, utilization rate of instruments, counted and cleaning time in 2 groups were recorded and analyzed. Results The average operation time and average lost blood of the routine group was 117.62±42.52 min and 53.14±50.69 ml, respectively, and the one of the optimized instruments group was 120.48±40.62 min, 56.10±49.87 ml, respectively, with no significant difference between the two groups (P=0.112, P=0.231, respectively). The utilization rate of instruments in the routine group (58.02%±2.39%) was significantly lower than that of the optimized instruments group (94.00%±1.48%, P=0.014). The counted time, the loading and unloading time and the cleaning time of instruments in the routine group was 112.00±26.00 s, 70.00±15.00 s, 1 010.00±130.00 s, respectively, much longer than the time of the optimized instruments group, which was 65.00±23.00 s, 20.00±4.00 s, 665.00±69.00 s, respectively. There was a statistical difference between the two groups (P=0.028, P=0.011, P=0.039, respectively). The value of instruments in the routine group (177 574.00±14 438.00 yuan) was apparently higher than that of the optimized instruments group(132 027.00±10 311.00 yuan), with a statistical difference (P=0.032). Conclusion It is demonstrated that optimized management of surgical instruments package in VATS lobectomy can greatly improve the utilization rate of instruments and work efficiency, with no effects on the operation time and amount of bleeding in lobectomy.

关键词: 胸腔镜手术; 器械包; 肺癌

Key words: Thoracoscopic surgery; surgical instruments package; lung cancer

引用本文: 涂雪花, 张祥蓉, 郝淼, 许宁惠, 王文凭, 车国卫. 胸腔镜肺叶切除术器械包需要优化吗?. 中国胸心血管外科临床杂志, 2018, 25(11): 967-970. doi: 10.7507/1007-4848.201802027 复制

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