胸腔引流袋的研發與應用

Development and Application of Chest Drainage Bags

目的：報告胸腔引流袋的研發和臨床應用。
方法：我們從2016年5月開始設計引流袋來代替胸瓶。為了排除空氣，最初在引流袋上角打了一個3毫米的小孔。2020年2月起，在引流袋的上角置換3公分x 2公分具有透氣性和不漏液的聚丙烯片。2021年4月起，我們透過機器製造胸腔引流袋，更換成5公分x 4公分丙烯酸共聚物片，並增加一輔助管。利用傾向評分匹配研究，比較胸瓶與胸腔引流袋應用於胸腔鏡肺葉切除手術後住院日數差異。
結果：共有674病人接受不同胸腔鏡手術後，使用胸腔引流袋。這些手術包括單側肺手術（409例，60.7%）、雙側肺手術（80例，11.9%）、食道切除術（92例，13.6%）、縱膈腫瘤手術（37例，5.5%)、肝腫瘤手術（24例，3.0%）、肋膜剝脫術（20例，3.0%）和其他手術（9例，1.3%）。沒有發生與胸腔引流袋相關的併發症。傾向評分匹配研究顯示；病人使用胸腔引流袋比使用胸瓶術後住院日數短（5.10±0.24 vs 6.14±0.27，p = 0.005）。胸腔引流袋方便病人使用，讓病人手術後早期下床活動。
結論：新開發的胸腔引流袋安全，容易使用，適用於胸腔鏡手術後引流。這引流裝置可以提高醫療照護品質。

Objective: To report the development and clinical application of chest drainage bags.
Methods: We started to design drainage bags to replace chest bottles in May 2016. Initially, a 3 mm hole was created at one corner to let air out. In February 2020, we placed a 3 cm x 2 cm breathable and liquid-tight polypropylene sheet was placed on the corner of the drainage bag. As of April 2021, we started to produce the chest drainage bags with a machine using a 5 cm x 4 cm acrylic copolymer sheet and auxiliary tubing in the other upper corner. A propensity score matching study was used to compare the length of postoperative stay after thoracoscopic lung resection using chest bottles and chest drainage bags.
Results: We have used these chest drainage bags in 674 patients undergoing various thoracoscopic surgeries, including unilateral lung surgery (n = 409, 60.7%), bilateral lung surgery (n = 80, 11.9%), esophagectomy (n = 92, 13.6%), mediastinal tumor surgery (n = 37, 5.5%), liver tumor surgery (n = 24, 3.0%), decortication (n = 20, 3.0%), and other surgeries (n = 9, 1.3%). No device-related complications were observed. A propensity score matching study showed that patients using chest drainage bags had shorter postoperative stays than those using chest bottles (5.10±0.24 vs 6.14±0.27, p = 0.005). The drainage bag increases patient convenience and promotes patients’early ambulation.
Conclusion: The newly developed drainage bag is safe and easy to use for drainage after thoracoscopic surgery. The device can improve the quality of medical care.