细导管排气减压治疗COPD并发气胸的效果研究  

Clinical Value of Fine Catheter Decompression Therapy in COPD Patients with Pneumothorax

作　　者：李娜[1] 贾玮[2] 李月川[2] 朱亚茜[2] 张冬睿[2] 马辉[2] 潘建辉[2] 李毅[2] 

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

出　　处：《天津医药》2012年第5期471-473,共3页Tianjin Medical Journal

摘　　要：目的:评价细导管排气减压治疗慢性阻塞性肺疾病(COPD)并发气胸的有效性及安全性。方法:选取COPD并发气胸的患者112例,按患者就诊顺序随机分为常规组(57例)和气体分析组(55例)。常规组选用标准引流管,气体分析组根据先后2次胸腔内气体分析的结果决定气胸的类型,并据此选择细导管抽气治疗或细导管与水封瓶相连行闭式引流术治疗。结果:插管减压24 h内,常规组的患肺完全复张率(17.54%)与气体分析组(21.82%)差异无统计学意义(P>0.05)。5 d内气体分析组的患肺复张率低于常规组,皮下气肿和引流失效发生率高于常规组,差异均有统计学意义(P<0.01)。2组脱管发生率差异无统计学意义(P>0.05)。结论:COPD并发气胸气体分析后以交通性及张力性气胸为主,标准胸腔引流管疗效优于细导管,细导管引流仅适用于闭合性气胸。Objective： To explore the efficacy and the safety of fine catheter decompression therapy in patients with chronic obstructive pulmonary disease （COPD） and pneumothorax. Methods： One hundred arid eleven COPD patients with pneumothorax were randomly divided into routine therapy group （n=57） and fine catheter decompression therapy group （n= 55）. The standard drainage tube was used in routine therapy group. Based on the 2 times of evaluation results of gas partial pressure of pleural cavity, the type of pneumothorax can be accurately determined, and the effective exhaust measures were taken. Results： There was no significant difference in the full reexpansion rate of the lung within 24 h intubation between rou- tine therapy group （17.54%） and fine catheter decompression therapy group （21.82%）. In 5 days, the full re-expansion rate of damaged lung was lower in fine catheter decompression therapy group than that of routine therapy group, and incidences of subcutaneous emphysema and failed drainage were significantly higher in fine catheter decompression therapy group than that of routine therapy group （P 〈 0.01）. There was no significant difference in detached incidence between two groups （P 〉 0.05）. Conclusion： The efficacy and the incidence of complications are higher in fine catheter decompression therapy group than that of routine therapy group, which sugges that this method is not suitable for the clinical application.

关 键 词：肺疾病 慢性阻塞性 气胸 减压 血气分析 

分 类 号：R561.4[医药卫生—呼吸系统]