微创胸腔置管治疗气胸的疗效评价  

Effects of pleural drainage using central venous catheter and simple aspiration in treatment of spontaneous pneumothorax:a clinical comparative study

作　　者：马万里[1] 章翔[1] 宋蓉[1] 陆宏扬[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院呼吸内科,武汉430022

出　　处：《中华医学杂志》2007年第25期1749-1751,共3页National Medical Journal of China

基　　金：卫生部呼吸系疾病重点实验室开放基金 (WHK04010)

摘　　要：目的比较微创胸腔置管(采用中心静脉导管)引流与传统的多次胸腔穿刺抽气法治疗气胸的疗效,并对其进行经济学评价。方法 2005年3月1日至2006年8月31日入院病例中首次发病的46例自发性气胸患者,随机分为两组,分别接受中心静脉导管置管引流(微创置管组)与多次胸腔穿刺抽气(多次胸穿组)治疗。以治疗有效率、治疗后的剩余气胸量等评价疗效,以主要耗材费用、平均住院天数、主要治疗措施时数等评价其经济性。结果微创置管组治疗有效率100%、多次胸穿组治疗有效率91.30%;出院时微创置管组平均剩余气胸量4.17%、多次胸穿组18.62%;1周随访时微创置管组平均剩余气胸量0.53%、多次胸穿组7.59%。微创置管组使用中心静脉导管、引流瓶、复查胸部 X 线片等耗材,人均耗材费用264.79元;多次胸穿组使用穿刺包、复查胸片等耗材,人均费用233.62元。微创置管组比多次胸穿组人均住院天数、防治感染天数分别减少2.36、2.13 d,人均吸氧时间减少36.7 h。结论微创胸腔置管的疗效明显优于多次胸腔穿刺抽气治疗,住院总费用降低,建议将微创胸腔置管作为治疗自发性气胸的首选方法。Objective To compare the curative effects and expenses of pleural drainage by using central venous catheter and of simple aspiration by thoracentesis in treatment of spontaneous pneumothorax. Methods 46 patients with spontaneous pneumothorax were randomly divided into 2 equal groups ： Group A, treated with pleural drainage by using central venous catheter, and Group B, treated with simple aspiration by thoracentesis. The curative rate and average residual volume after treatment were used to evaluate the curative effects. The average hospitalization days, duration of treatment, and expenses for medical materials were used to evaluate as the economic index. Results ①The effective rates were 100% and 91.30% in Groups A and B respectively. ②The average residual volume of pneumothorax at the time of discharge from hospital of Group A was 4.17% , significantly lower than that of Group B （ 18.62% , P 〈 0.05 ）. ③ The average residual volume of pneumothorax 1 week after discharge of Group A was 0.53% , significantly lower than that of Group B （7.59% , P 〈0. 01 ）, ④The expense for medical materials of Group A was 264.79 Yuan RMB, a little bit more than that of Group B （233.62 Yuan RMB ）, ⑤The hospitalization time of Group A was 5.32 days, significantly shorter than that of Group B （7.68 days, P 〈 0.05 ）, The duration of treatment with antibiotics of Group A was 3.46 days, significantly shorter than that of Group B （ 5.59 days, P 〈 0.05 ）. The time of oxygen inhalation of Group A was 86.4 hours, significantly shorter than that of Group B （ 133.1 hours, P 〈 0.01 ）, Conclusion With higher curative effect and lower expenses, pleural drainage by using central venous catheter is superior to simple aspiration in treatment of spontaneous pneumothorax, and can be the first choice,

关 键 词：导管 留置 气胸 

分 类 号：R561[医药卫生—呼吸系统]