Study On The Influence Of The Position Of The Intercostal Incision Of Single Port Thoracoscopy On Postoperative Pain And Trauma

Objective:By observing and analyzing the differences in the impact of different incision positions of intercostal muscles on patients’ postoperative pain in uniportal video-assisted thoracoscopic surgery,.The aim is to provide references for how to reduce postoperative pain,reduce surgical trauma and body stress,and promote rapid functional recovery.Methods:From June 2020 to December 2020,60 patients those who underwent single-port thoracoscopic surgery and met the enrollment conditions in the Second Department of Thoracic Surgery of Yunnan Cancer Hospital were selected.Using a randomized control method,they were randomly divided into group A and group B according to the order of the random table.Group A:Cut the skin and cut the intercostal muscles along the parallel ribs in the middle of the intercostal cavity to enter the chest cavity;Group B:Cut the skin and cut the intercostal muscles along the upper edge of the next rib to enter the thoracic cavity.The observation indicators of the two groups of patients were as follows:intraoperative intercostal vascular injury,postoperative pain score,postoperative analgesic pump self-pressing times,postoperative atelectasis,effective cough,serum expression level of inflammatory mediators(y Interferon,TNF-α,IL-6,CRP,PCT).The basic description of counting data represented by examples and composition ratio,and the normally distributed measurement data is represented by mean data ± standard deviation,and the skewed distribution measurement data is represented by quartiles,and the normal distribution measurement data between two groups are compared using two independent samples t test,and the skewed distribution of measurement data between the two groups were compared by two samples rank sum test,and the variance analysis of repeated design data was used to compare the repeated design data,p<0.05 indicates that the difference is statistically significant.Results:1.Compared with group B,patients in group A had lower postoperative pain scores,and the difference was statistically significant(F=4.200,p=0.045).2.The incidence of postoperative atelectasis in group A was lower than that in group B(2.56%vs19.05%).The difference was statistically significant(2=4.855,p=0.028).3.The number of analgesic pumps in group A was lower than that in group B,the difference was statistically significant(Z=-2.121,p=0.034).4.There was no significant difference in serubr443r rm indexes between the two groups before operation.After operation,the expression level of IL-6 in group A was lower than that in group B(F=4.213,p=0.045),and the difference was statistically significant;There was no significant difference in the levels of interferon-y,TNF-α,CRP,and PCT after operation.5.There was no significant difference between group A and group B in terms of intracostal vascular injury.Conclusions:When the intercostal muscles were cut off from the middle of the intercostal region during Uniportal Video-assisted Thoracic Surgery,the postoperative pain of patients was less,the incidence of atelectasis was lower,the number of self-pressing of the analgesia pump was less,and the trauma to the body and the corresponding stress response were relatively less.