腹腔镜检查时使用两种引流管的盆腔残余液体：一项随机对照试验

Chan Karen, Welsh Alec, Abbott Jason

University of New South Wales, Sydney, New South Wales, Australia.

Obstet Gynecol. 2008 Jun;111(6):1293-7. doi: 10.1097/AOG.0b013e31817589cd.

OBJECTIVE

To compare the estimated residual pelvic fluid volume in women receiving suction or nonsuction drains after gynecologic laparoscopic surgery using transvaginal ultrasonography.

METHODS

In this randomized comparative study of women undergoing a laparoscopic surgical procedure for benign gynecologic conditions, women requiring postoperative drainage were assigned to receive either a suction or a nonsuction drain. Immediately before drain removal, women had transvaginal ultrasonography and estimation of the residual fluid volume using the formula pi/6 x D(1) x D2 x D(3), where D(1) and D(2) were obtained in the sagittal plane and D(3) in the coronal plane.

RESULTS

Sixty-nine women consented to the study; 51 received a drain, and 47 complete data sets were obtained. The two groups had similar demography, and no complications were reported intraoperatively or postoperatively. The median volume of fluid drained postoperatively was not significantly different: 170.0 mL (range 5-1,370 mL) for nonsuction and 160.0 mL (range 10-550 mL) for suction. The median residual fluid volume estimated in the pelvis postoperatively by transvaginal ultrasonography was 0.24 mL (interquartile range 0.00-2.45) in the nonsuction group versus 1.91 mL (interquartile range 0.32-7.72) in the suction group. This was statistically different (z=-2.10, P=.04) for nonsuction versus suction drains.

CONCLUSION

There is a statistically reduced residual fluid volume using nonsuction drains after laparoscopic surgery. However, with both types of drain, these residual volumes are well below what is considered physiologic, and there is likely little clinical difference. Both nonsuction and suction drains are equally effective in removing fluid from the peritoneal cavity after gynecologic laparoscopic surgery.

CLINICAL TRIAL REGISTRATION

Australian New Zealand Clinical Trials Registry, www.anzctr.org.au, ACTRN12608000109303.

LEVEL OF EVIDENCE

目的

采用经阴道超声检查比较妇科腹腔镜手术后使用吸引引流管或非吸引引流管的女性盆腔残余液体量的估计值。

方法

在这项针对因良性妇科疾病接受腹腔镜手术的女性的随机对照研究中，需要术后引流的女性被分配接受吸引引流管或非吸引引流管。在拔除引流管前即刻，对女性进行经阴道超声检查，并使用公式π/6×D(1)×D2×D(3)估计残余液体量，其中D(1)和D(2)在矢状面获得，D(3)在冠状面获得。

结果

69名女性同意参与研究；51名接受了引流管，获得了47个完整数据集。两组人口统计学特征相似，术中及术后均未报告并发症。术后引流的液体量中位数无显著差异：非吸引组为170.0 mL（范围5 - 1370 mL），吸引组为160.0 mL（范围10 - 550 mL）。术后经阴道超声检查估计盆腔残余液体量中位数，非吸引组为0.24 mL（四分位间距0.00 - 2.45），吸引组为1.91 mL（四分位间距0.32 - 7.72）。非吸引引流管与吸引引流管相比，差异有统计学意义（z = -2.10，P = 0.04）。