自制环形排烟装置在开放性甲状腺手术中的应用效果评估

Evaluation of the application effect of a self-made annular smoke evacuation device in open thyroid surgery

摘要:

背景与目的 随着电外科设备在开放性甲状腺手术中的广泛应用，术中产生的烟雾成为影响手术视野、降低操作效率及威胁医护人员健康的重要隐患。目前临床普遍采用助手手持吸引器局部排烟，存在排烟范围有限、操作干扰大、人力成本高等问题。本研究旨在评估一种基于现有材料自制的环形排烟装置在开放性甲状腺手术中的排烟效果、安全性、可行性及医护人员满意度。方法 纳入2024年3月─6月江苏省宿迁市第一人民医院收治的82例接受开放性甲状腺乳头状癌手术患者，随机分为观察组和对照组，每组各41例。观察组术中使用自制环形排烟装置进行持续排烟，对照组由助手手持吸引杆排烟。比较两组术中距离术野30 cm处PM2.5浓度、手术时间、术中出血量及医护人员对排烟效果的满意度。结果 切割甲状腺组织时，观察组术中PM2.5浓度为（63.26±11.71）μg/m³，术中空气质量等级为“良”，对照组为（126.35±40.12）μg/m³，术中空气质量等级为“轻度至重度污染”，差异有统计学意义（P<0.05）。观察组单侧、双侧手术时间分别为（31.25±11.36）min、（71.13±17.12）min，术中出血量分别为（10.5±5.3）mL、（18.6±5.5）mL；对照组为（39.27±15.42）min、（78.35±22.35）min和（12.5±5.8）mL、（20.5±6.5）mL，两组间差异无统计学意义（均P>0.05）。观察组医护人员满意度明显高于对照组（97.6% vs. 31.7%，P<0.05）。结论 自制环形排烟装置在开放性甲状腺手术中应用效果良好，能有效降低术区烟雾浓度、提升术野清晰度、减少对医护人员健康的影响，同时不影响手术效率及安全性。该装置成本低廉、组装简便，术后可转为引流管使用，无需额外耗材，具备资源再利用优势，有较高的实用价值和推广前景。

Abstract:

Background and Aims With the widespread use of electrosurgical devices in open thyroid surgery, the surgical smoke generated during procedures has become a significant concern, as it compromises surgical visibility, reduces operational efficiency, and poses health risks to medical staff. Currently, local smoke evacuation is commonly performed by an assistant using a handheld suction device, which is limited in range, interferes with surgical procedures, and increases labor costs. This study aimed to evaluate the effectiveness, safety, feasibility, and staff satisfaction associated with a self-made annular smoke evacuation device constructed from readily available materials for use in open thyroid surgery.Methods A total of 82 patients undergoing open surgery for papillary thyroid carcinoma at Suqian First People's Hospital between March and June 2024 were randomly assigned to an observation group and a control group (41 patients each). During surgery, the observation group used a self-made annular smoke evacuation device for continuous smoke removal, while the control group used conventional manual suction via an assistant. Outcomes compared between the two groups included PM2.5 concentrations 30 cm above the surgical field, operative time, intraoperative blood loss, and medical staff satisfaction with smoke removal.Results During thyroid tissue dissection, the PM2.5 concentration in the observation group was (63.26±11.71) μg/m³, corresponding to a "good" air quality level, while in the control group it was (126.35±40.12) μg/m³, ranging from "mild to severe pollution"—a statistically significant difference (P<0.05). In the observation group, operative times for unilateral and bilateral procedures were (31.25±11.36) min and (71.13±17.12) min, respectively, with intraoperative blood loss of (10.5±5.3) mL and (18.6±5.5) mL. In the control group, times were (39.27±15.42) min and (78.35±22.35) min, with blood loss of (12.5±5.8) mL and (20.5±6.5) mL, respectively—all differences not statistically significant (all P>0.05). Staff satisfaction was significantly higher in the observation group compared to the control group (97.6% vs. 31.7%, P<0.05).Conclusion The self-made annular smoke evacuation device demonstrated favorable results in open thyroid surgery, effectively reducing surgical smoke concentration, improving visibility, and minimizing health risks to medical staff without compromising surgical efficiency or safety. The device is cost-effective, easy to assemble, and can be repurposed postoperatively as a drainage tube, requiring no additional consumables. Its reusability and ease of integration offer strong practical value and clinical applicability.