负压吸引辅助自体血胸腔注射治疗顽固性气胸的有效性及安全性观察  

Evaluation of the efficacy and safety of autologous blood pleurodesis assisted with vacuum aspiration in treatment of intractable pneumothorax

作　　者：王信杰[1] 徐玉荣[1] 马晓辉[1] 

机构地区：[1]山东省胸科医院,济南250013

出　　处：《山东医药》2012年第18期13-15,共3页Shandong Medical Journal

摘　　要：目的观察负压吸引辅助下应用自体血胸腔注射治疗顽固性气胸的有效性及安全性。方法将146例顽固性气胸患者随机分为两组,均经胸腔闭式引流管行持续负压吸引,变换不同体位至患侧肺复张或基本复张;治疗组经引流管胸腔内注射自体血50～100 mL,对照组经引流管胸腔内注射5%葡萄糖100 mL加红霉素0.75～1 g。结果治疗组1次治疗成功67例,共治疗成功89例;对照组分别为29例及47例;两组1次治疗成功率、总成功率比较,P均<0.05。术后随访2 a,治疗组复发4例,对照组复发10例;两组复发率比较,P<0.05。治疗组出现轻微胸痛6例,剧烈胸痛0例,发热2例;对照组分别为24、11、9例。两组不良反应发生率比较,P<0.05。结论负压吸引辅助自体血胸腔注射治疗顽固性气胸疗效确切,不良反应少,气胸复发率低。Objective To evaluation of the efficacy and safety of autologous blood pleurodesis under vacuum aspiration in treatment of intractable pneumothorax. Methods 146 patients with intractable pneumothorax were randomly divided into two groups. All the patients were given closed thoracic drainage and continuous negative pressure drainage suction. The patients in the treatment group were injected 50 to 100 mL autologous blood into the pleura cavity under vacuum suctions, and the patients in the control group were injected 100 ml 5% glucose and 0.75 to 1 gram erythromycin. During the course of the treatment, all the patients change different posture until the affected lung recruited or almost recruited. Results 67 patients（72.8% ）in the treatment group were successfully cured after once treatment and 89 patients （96.7%）were suc- cessfully cured at last. 29 patients（53.7% ） in the control group were successfully cured after once treatment and 47 patients （ 87.0% ） were successfully cured wholly. There were statistical significance between the once treatment success rate and whole success rate of the two groups （P 〈 0.05 ）. In 2-year follow-up study, 4 patients （4.5%）recurred in the treat- ment group and 10 patients （21.3%）recurred in the control group. There was statistical significance between the recurrence rate of the two groups（P 〈0.05）. There were 6 patients（6.5% ）with light chest pain, 2 patients （2%）with fever, and no patient with intense chest pain in the treatment group. There were 24 patients （44.4%） with light chest pain, 11 patients （20.4%） with intense chest pain, and 9 patients （16.7%）with fever. There was statistical significance between the ad- verse reaction rates of the two groups （ P 〈 0.05 ）. Conclusion Autologous blood pleurodesis assisted with vacuum aspiration for intractable pneumothorax has sure therapeutic effect, few adverse reaction and low recurrence rate. Autologous blood injection assisted under vacuum suction in the treatment of

关 键 词：自体血疗法 负压吸引 胸膜腔粘连术 气胸 

分 类 号：R655.2[医药卫生—外科学]