原发性自发性气胸术后负压吸引对患者的影响研究  

Influence of Suction on Patients with Primary Spontaneous Pneumothorax after Thoracoscopy

作　　者：王晓东[1] 孙大强[2] 

机构地区：[1]天津医科大学研究生院,天津市300070 [2]天津市胸科医院胸外科,天津市300051

出　　处：《中国全科医学》2012年第6期635-636,640,共3页Chinese General Practice

摘　　要：目的探讨胸膜腔负压吸引对胸腔镜肺大疱切除术后原发性自发性气胸患者的影响,评价术后常规应用胸膜腔负压吸引的必要性。方法对连续收住我院的符合入选标准的患者68例,术后应用随机数字表法分为负压组和对照组。比较两组术后48 h累积胸腔积液引流量、胸腔内持续有气时间;比较第1、2天胸腔积液内乳酸脱氢酶(LDH)的水平。结果负压组术后48 h累积胸腔积液引流量(377.9±39.0)ml较对照组的(305.6±45.3)ml明显升高,差异有统计学意义(t=7.055,P<0.05)。负压组胸腔内持续有气体的中位时间为72.00 h[95%CI(63.73,80.30)],对照组胸腔内持续有气体的中位时间为89.65 h[95%CI(81.75,97.95)],负压组胸腔内持续有气体时间较对照组明显缩短,差异有统计学意义(χ2=6.918,P=0.009);超过6 d胸腔内仍有气体者负压组1例(2.9%),对照组2例(5.9%)。负压组术后第1天、第2天胸腔积液内LDH水平较对照组均明显升高,差异有统计学意义(P<0.05)。结论负压吸引的引流时间较对照组短,但其对胸膜的急性炎症损伤也较重。负压吸引作为一种治疗手段,不应该在术后常规应用。Objective To investigate the influence of suction on patients with primary spontaneous pneumothorax after thoracoscopy, and to evaluate the necessity of routine suction after thoracoscopy. Methods 68 patients received video assisted thoracoscopic surgery for pulmonary bulla resection were divided into suction group and control group by using random number ta- ble. 48 h cumulative pleural effusion and the duration of air in pleura were compared between the two groups ; LDH levels in pleu- ral effusion on the first day and second day after thoracoscopy were also compared. Results The 48 h cumulative pleural effusion of suction group [ （377. 9 ~39. 0） ml] was significantly higher than that in control group [ （305.6 _＋45.3） ml] （t =7. 055, P 〈 0. 05 ） . The median persisting air duration of suction group [ 72. 00 h, 95% CI （63. 73, 80. 30） ] was significantly shorter than that of the control group [89.65 h, 95%CI （81.75, 97.95）] （X~ =6.918, P=0.009） . 1 ease in the suction group （2. 9% ） and 2 eases in the control group （5.9%） still had air in pleura 6 days after thoracoseopy. LDH level of pleural effusion in suction group was significantly higher than that in control group 1 day and 2 days after thoraeoscopy （ P 〈 0. 05） . Conclusion Suction indeed can shorten drainage time of pleural effusion, but it can cause acute inflammatory damage to the pleura. Suction can be used as a treatment but not a routine one.

关 键 词：气胸 胸腔镜检查 负压吸引 引流术 

分 类 号：R561.4[医药卫生—呼吸系统]