恶性胸腔积液引流管堵塞或引流不畅的影响因素  

Related factors of blockage of catheter drainage or inadequate drainage for malignant pleural effusion

作　　者：苗凯玲 李春燕[1] 侯惠如[1] MIAO Kailing;LI Chunyan;and HOU Huiru(Department of Respiratory Medicine,General Hospital of PEA,Beijing 100853,China)

机构地区：[1]解放军总医院呼吸科,北京100853

出　　处：《武警医学》2018年第9期857-860,共4页Medical Journal of the Chinese People's Armed Police Force

基　　金：总后勤部卫生部保健专项科研课题(14BJZ05)

摘　　要：目的探讨恶性胸腔积液(malignant pleural effusion,MPE)置管引流堵管或引流不畅的相关因素。方法选取2015-11至2017-12行MPE置管引流患者161例,统计患者性别、年龄、置管时间、胸腔积液状态、导管情况等信息,分析MPE置管引流堵管或引流不畅相关危险因素。结果 161例共发生32例引流管堵塞或引流不畅,不同性别、年龄、BMI、原发病、合并症、抗凝药物及靶向药物使用情况、胸腔注药患者间置管引流堵管或引流不畅发生率间无统计学差异(P>0.05),置管时间较长、管口上抬高出液面、积液内含纤维素膜及血块、血小板计数异常、胸水蛋白阳性患者,置管引流堵管或引流不畅发生率较高(P<0.05);Logistic回归分析表明,管口上抬高出液面(OR 2.578,95%CI 1.357~4.846)、积液内含纤维素膜及血块(OR 3.218,95%CI 1.651~10.056)、封管方法(OR 1.689,95%CI 1.427~4.297)为MPE置管引流堵管或引流不畅发生的重要危险因素(P<0.05)。结论 MPE置管引流发生引流管堵塞的主要危险因素包括管口上抬高出液面、积液内含纤维素膜及血块、封管方法,临床可参照上述危险因素采取干预措施。Objective To investigate the factors related to blockage of catheter drainage or inadequate drainage for malignant pleural effusion（ MPE）. Methods One hundred and sixty-one cases of malignant pleural effusion with catheter drainage treated in our hospital between November 2015 and December 2017 were selected. According to the patency of the drainage process,the patients were divided into two groups： the drainage patency group and the blockage or poor drainage group. Information about the two groups was collected,including gender,age,time of catheterization,pleural effusion and catheter status. The related factors of blockage of catheter drainage or inadequate drainage for MPE were analyzed. Results There were 32 cases of blockage of catheter drainage or inadequate drainage. There was no statistically significant difference in the incidence of blockage of catheter drainage or inadequate drainage between patients who were different in sex,age,BMI,primary diseases,complications,anticoagulant and targeted drug use or between patients who received thoracic injection and those who did not（ P〈0. 05）. A long duration of catheterization,the mouth of the catheter above the liquid surface,cellulosic membrane and blood clots in the effusion,abnormal counts of platelets and positive hydrothorax protein were risk factors for blockage of catheter drainage or inadequate drainage. Logistic regression analysis confirmed that a high level of liquid surface（ OR 2. 578,95% CI 1. 357-4. 846）,cellulosic membrane and clot（ OR 3. 218,95% CI 1. 651-10. 056）,and tube-sealing methods（ OR 1. 689,95% CI 1. 427-4. 297） were important risk factors（ P〈0. 05） for blockage of catheter drainage or inadequate drainage in case of MPE. Conclusions Catheter blockage is likely to occur during drainage in case of malignant pleural effusion,and the main risk factors include the elevation of the liquid surface,cellulose membrane and blood clots in the effusion and tube-sealing methods. Corresponding interventions can be implem

关 键 词：恶性胸腔积液 置管引流 堵管相关因素 

分 类 号：R734.2[医药卫生—肿瘤]