CAJ | 학술논문

目的观察医用外科软组织扩张器的力学特性及临床应用结果.方法应用拉力测试装置对医用外科软组织扩张器和金属腹部牵开器进行力学实验,测量在不同的初始牵引力下,牵引器在持续牵引过程中随时间发生的牵引力变化及位移变化.再通过临床对照研究,比较医用外科软组织扩张器与传统的金属牵开器的临床应用结果.结果力学实验结果提示,随时间的延长,医用外科软组织扩张器的残留牵引力逐渐递减,在牵引1h后,残留牵引力较基础牵引力平均减少了10％ - 13％；而金属腹部牵开器的牵引力在牵引过程中没有发生变化.临床试验中,共120例患者入组,试验组及对照组各60例.试验组50/60例(83.3％)手术使用后,外科医生对术野显露的评价为非常满意,10/60例(16.7％)评价为满意,平均使用效果评分为4.83分；对照组为35/60例(58.3％)评价非常满意,评分4.58分(P＜0.05).而在围手术期临床结果分析中,试验组与对照组患者在术中出血量、术后胸腔积液发生率和住院天数上结果相似,差异无统计学意义.两组患者围手术期疼痛评分最高值在试验组及对照组患者中分别为(2.60±0.65)分和(4.10±0.45)分(P＜0.05),至术后6个月,两组患者慢性疼痛发生率分别为20/60(33.3％)和44/60(73.3％),持续时间分别为(1.80±1.19)个月和(3.70±1.84)个月(P＜0.01).试验组在术后所用的器械清理时间平均为(5.0 ±2.3)min；而对照组为(370.0±5.8) min(P＜0.01).结论医用外科软组织扩张器在临床使用中评价良好,临床收益与传统的腹部牵开器相似,但减少了术后伤口感染的机会,并显著降低了患者术后的疼痛程度并减少了术后疼痛时间.
목적 관찰의용외과연조직확장기적역학특성급림상응용결과.방법 응용랍력측시장치대의용외과연조직확장기화금속복부견개기진행역학실험,측량재불동적초시견인력하,견인기재지속견인과정중수시간발생적견인력변화급위이변화.재통과림상대조연구,비교의용외과연조직확장기여전통적금속견개기적림상응용결과.결과 역학실험결과제시,수시간적연장,의용외과연조직확장기적잔류견인력축점체감,재견인1h후,잔류견인력교기출견인력평균감소료10％ - 13％；이금속복부견개기적견인력재견인과정중몰유발생변화.림상시험중,공120례환자입조,시험조급대조조각60례.시험조50/60례(83.3％)수술사용후,외과의생대술야현로적평개위비상만의,10/60례(16.7％)평개위만의,평균사용효과평분위4.83분；대조조위35/60례(58.3％)평개비상만의,평분4.58분(P＜0.05).이재위수술기림상결과분석중,시험조여대조조환자재술중출혈량、술후흉강적액발생솔화주원천수상결과상사,차이무통계학의의.량조환자위수술기동통평분최고치재시험조급대조조환자중분별위(2.60±0.65)분화(4.10±0.45)분(P＜0.05),지술후6개월,량조환자만성동통발생솔분별위20/60(33.3％)화44/60(73.3％),지속시간분별위(1.80±1.19)개월화(3.70±1.84)개월(P＜0.01).시험조재술후소용적기계청리시간평균위(5.0 ±2.3)min；이대조조위(370.0±5.8) min(P＜0.01).결론 의용외과연조직확장기재림상사용중평개량호,림상수익여전통적복부견개기상사,단감소료술후상구감염적궤회,병현저강저료환자술후적동통정도병감소료술후동통시간.
Objective To observe the mechanic characteristics and clinical results of self-help surgical retractor.Methods Use tensile testing device to do the mechanic test with the self-help surgical retractor and the medal abdominal retractor,measuring the change of traction and displacement when the two kinds of tractor were under different initial traction,and received continuous traction.We also compare the clinical results of the two retractors.Results The mechanic test show that the left traction of self-help surgical retractor decreased with time,the average left traction decreased by 10％-13％ after 1h.In the clinical test,there were 120 patients in total,with 60 in experimental group and 60 in control group.In the experimental group,surgeons gave 50/60 (83.3％) very good evaluation.In the analysis of perioperative clinical results,there were no difference between the two groups.The vas paining score of the experimental group and the control group was 2.6 ± 0.65 and 4.1 ± 0.45 ( P ＜ 0.05 ),6 months after operation,the incidence of chronic paining was 20/60 (33.3％) and 44/60 (73.3％),and duration was ( 1.80 ± 1.19)months and (3.70 ± 1.84) months ( P ＜ 0.01 ).The spending of instrument cleaning of the experimental group was significantly less.Conclusion The self-help surgical retractor was evaluated well in the clinical use,and it was similar with the abdominal retractor in clinical profits,but it reduced the incidence of wound infection and significantly reduced the extent and duration of paining.