应用自制引流装置及改良胸腔闭式引流术治疗自发性气胸的临床研究  

Clinical research of spontaneous pneumothorax treated by self-made drainage device and modified closed thoracic drainage

作　　者：黄峻岭 

机构地区：[1]河北省蠡县医院胸外科,071400

出　　处：《河北医药》2010年第10期1213-1215,共3页Hebei Medical Journal

基　　金：保定市科学技术研究与发展攻关计划项目(编号:09ZF101)

摘　　要：目的探讨自发性气胸(SP)简单有效的而且适宜基层医疗机构普及的方法。方法 103例次患者随机分为观察组(n=52)和对照组(n=51)。观察组采用自制简易胸腔闭式引流装置及肋间小切口方法行胸腔闭式引流术。对照组采用传统大口径胸引流管及肋间常规切口方法行胸腔闭式引流术。2组分别观察治愈率、置管时间、切口愈合时间、切口疼痛、患侧肩背部疼痛及肺脏层胸膜受刺激所致牵扯不适感、切口感染、皮下气肿、引流管堵塞等并发症发生情况。结果观察组总有效率92.3%(治愈率84.6%),对照组总有效率96.1%(治愈率90.2%)。2组间比较治愈率、有效率、置管时间差异无统计学意义(P>0.05),但观察组并发症出现较对照组少,尤其在切口疼痛、患侧肩背部疼痛及肺脏层胸膜受刺激所致牵扯不适感和切口感染等方面(P<0.05)。结论利用一次性输液管自制胸腔闭式引流装置及改良胸腔闭式引流术治疗SP,具有手术操作简单,易掌握,装置制作简便,取材方便,疗效可靠,并发症少的优点,适宜基层医院救治患者使用,值得推广。Objective To explore the therapy for spontaneous pneumothorax （SP） by using a simple, effective and appropriate way to be popularized in primary health care institution. Methods 103 patients were randomly divided into the observation group and control group. The observation group was treated with self-made simple closed thoracic drainage device and the method of intercostal small incision, however, the patients in control group were treated by using the traditional large-caliber chest tube and the intercostal incision method of conventional line closed thoracic drainage. The cure rate, remaining time of drainage, wound healing time, incision pain, ipsilateral shoulder pain and lung irritation due to pleural layers involved discomfort, wound infection, subcutaneous emphysema, tube blockage complications were observed in both groups. Results The total effective rate in observation group was 92.3% （cure rate： 84.6% ）,which in control group was 96. 1% （cure rate： 90.2% ）. There were significant difference in the cure rate, effictive rate, remaining time of drainage between the two groups（ P 〉 0.05 ）, but the complications in observation group were significantly fewer than those in control group, especially in the incision pain, ipsilateral shoulder pain and lung irritation layer of pleura involved discomfort and wound infection（ P 〈 0.05）. Conclusion The use of a disposable infusion tube homemade thoracic drainage device and modified closed thoracic drainage in the treatment of SP is simple and easy to master, and the installment manufacture is simple, convenient, effective and reliable, fewer complications, suitable for use in grass-roots hospitals, which is worth promoting.

关 键 词：自制 引流装置 改良 胸腔闭式引流 自发性气胸 

分 类 号：R655[医药卫生—外科学]