不同部位行胸腔闭式引流治疗自发性气胸的临床分析  

A clinical analysis on closed chest drainage in treatment of spontaneous pneumothorax from different localities

作　　者：高小见[1] 侯伟[1] 

机构地区：[1]湖北省枣阳市第一人民医院心胸外科,湖北枣阳441200

出　　处：《临床和实验医学杂志》2016年第7期668-671,共4页Journal of Clinical and Experimental Medicine

摘　　要：目的对比不同部位行胸腔闭式引流治疗自发性气胸的临床效果。方法选取2012年1月至2015年1月收治的自发性气胸患者80例,将行锁骨中线第二肋间置管胸腔闭式引流治疗者设为锁骨中线组(39例),行腋前线第三肋间置管腔闭式引流治疗者设为腋前线组(41例)。治疗后,观察并记录两组患者的手术时间、术中出血量、引流时间、术后(12 h、24 h、48 h、72 h)疼痛程度、住院时间、治愈、中转、并发症(引流管通畅、漏气、脱出、感染、皮下气肿等)等情况。结果锁骨中线组和腋前线组的治愈率、中转率分别为82.05%和85.37%、17.95%和14.63%,差异均无统计学意义(P>0.05);两组患者的手术时间、术中出血量、引流时间、住院时间均无显著差异(P>0.05);腋前线组术后12h、24 h、48 h的疼痛程度均轻于锁骨中线组(P<0.05),至术后72 h时,两组患者的疼痛程度相当(P>0.05);腋前线组的并发症发生率为14.29%,显著低于锁骨中线组的28.13%(P<0.05)。结论锁骨中线第二肋间或腋前线第三肋间胸腔闭式引流治疗自发性气胸均有较好的疗效,但腋前线第三肋间置管胸腔闭式引流具有术后疼痛轻、并发症少等优势,值得临床推广应用。Objective To compare the advantages and disadvantages of closed chest drainage from different localities for treatment of patients with spontaneous pneumothorax. Methods A total of 80 patients with spontaneous pneumothorax treated in this hospital during January2012 to January 2015 were allocated in this study,among them 39 cases with thoracic drainage tube set at subclavian midline of second intercostal area were allocated in clavicular line treatment group,and those with closed drainage lumen set at third intercostal row anterior axillary line were allocated in third row axillary line treatment group（ 41 cases）,after treatment,and the operating time,amount of blood loss,drainage,postopera-tive（ 12 h,24 h,48 h,72 h） pain（ visual analog scale）,length of hospital stay,healing,transit and rates of complications（ drainage tube patency,leakage,prolapse,infection,subcutaneous emphysema,etc.） and so on were observed and recorded in patients of these 2 groups after treatment. Results The cure rate and transference rate in patients of clavicular line group and anterior axillary line group were 82. 05 % and85. 37 %,17. 95 % and 14. 63 % respectively,and the difference was not statistically significant（ P〈0. 05）. The operating time,amount of blood loss,drainage time and hospitalization time between these 2 groups were very close（ P〈0. 05）; the degree of pain in patients of axillary line group after 12 h,24 h and 48 h was lighter than those of patients in clavicular line group（ P〈0. 05）. The degree of pain in these 2 groups after 72 h was similar（ P〈0. 05）. The incidence of complications in patients of axillary line group was 14. 29%,it was significantly lower than that（ 28. 13%） of patients in mid- clavicular line group（ P〈0. 05）. Conclusion The treatment of patients with spontaneous pneumothorax treated by drainage at second intercostal clavicle midline anterior axillary line or third intercostal chest drainage have good effect,but the advantages of intercostal thoracix dr

关 键 词：自发性气胸 胸腔闭式引流 锁骨中线 腋前线 

分 类 号：R655[医药卫生—外科学]