经猪尾巴导管胸腔内灌注红霉素治疗老年慢性阻塞性肺疾病并发自发性气胸的效果  

Effect of intrathoracic infusion of erythromycin by pig tail catheter in the treatment of elderly patients with chronic obstructive pulmonary disease complicated with spontaneous pneumothorax

作　　者：丁宁 Ding Ning(Department of Thoracic Surgery,the First People′s Hospital of Hefei,Anhui Province,Hefei 230001,China)

机构地区：[1]安徽省合肥市第一人民医院胸外科,230001

出　　处：《中国综合临床》2020年第3期254-257,共4页Clinical Medicine of China

摘　　要：目的探讨通过猪尾巴腹腔引流导管胸腔内灌注红霉素治疗老年慢性阻塞性肺疾病合并自发性气胸的效果。方法回顾性分析2015年1月至2018年8月安徽省合肥市第一人民医院胸外科收治的慢性阻塞性肺疾病55例患者资料,均为老年男性,多次或首次出现自发性气胸,并通过简单随机化的方法分为两组(对照组和观察组)。观察组采用猪尾巴腹腔引流导管联合红霉素胸腔内灌注治疗,对照组采用通过常规胸腔闭式引流管胸腔内灌注红霉素治疗,观察组23例,对照组32例。比较两组患者通过不同引流管胸腔内灌注红霉素(1次/d)的时间、灌注效果、起效后夹管到拔管的时间、并发症的发生率、灌注总有效率及拔管出院后6个月内的复发率。结果观察组灌注红霉素时间为(3.00±0.32)d、拔管时间为(2.41±0.24)d均较对照组灌注红霉素时间(4.22±0.39)d、拔管时间(3.39±0.37)d短,差异均有统计学意义(t值分别为2.298、2.218,P值分别为0.026、0.032);观察组灌注红霉素后胸痛的发生率为17.4%(4/23),低于对照组灌注红霉素后胸痛的发生率46.9%(15/32),差异有统计学意义(P=0.023);观察组未出现休克和死亡的严重并发症,对照组出现1例;观察组与对照组顺利拔管出院患者分别为22例与23例,灌注无效最终带管出院患者分别为1例与8例,6个月内再次复发气胸分别为8例(含1例带管出院患者)与19例(含8例带管出院患者);观察组与对照组总体有效率、复发率、治愈率分别为95.7%(22/23)与71.9%(23/32)、34.8%(8/23)与59.4%(19/32)、65.2%(15/23)与37.5%(12/32),两组比较差异均有统计学意义(χ^2值分别为5.086、1.816、4.114,P均<0.05),观察组在疗效及复发率等方面均优于对照组。结论通过猪尾巴腹腔引流导管胸腔内灌注红霉素治疗老年慢性阻塞性肺疾病合并自发性气胸灌注时间短、拔管快、患者复发率低、并发症发生率低、耐受度好,灌注效果�Objective To observe the effect of injecting erythromycin into chest cavity through pig tail celiac drainage catheter in the treatment of senile chronic obstructive pulmonary disease with spontaneous pneumothorax.Methods From January 2015 to August 2018,55 patients with chronic obstructive pulmonary disease admitted to thoracic surgery of the First People′s Hospital of Hefei,Anhui Province were analyzed retrospectively.All of them were old men who had spontaneous pneumothorax for many times or for the first time.They were divided into two groups by simple randomized method(control group and observation group).The observation group was treated by intrathoracic injection of erythromycin through the abdominal drainage tube of pig tail,while the control group was treated by intrathoracic injection of erythromycin through the conventional closed thoracic drainage tube.There were 23 cases in the observation group and 32 cases in the control group.The time of injecting erythromycin(once a day)into the chest cavity through different drainage tubes,the effect of perfusion,the time from clamping to extubation,the incidence of complications,the total effective rate of perfusion and the recurrence rate within 6 months after discharge were compared between the two groups.Results The infusion time of erythromycin infusion and extubation in the observation group were(3.00±0.32)d and(2.41±0.24)d,which were shorter than those in the control group(4.22±0.39)d and(3.39±0.37)d,respectively,and the differences were statistically significant(t values were 2.298 and 2.218,respectively;P values were 0.026,0.032,respectively.The incidence of chest pain in the observation group was 17.4%(4/23),lower than that in the control group 46.9%(15/32),the difference was statistically significant(P=0.023).There was no serious complication of shock and death in the observation group,1 case in the control group;22 cases patients in the observation group and 23 cases patients in the control group were discharged from the hospital after extubatio

关 键 词：猪尾巴腹腔引流导管 红霉素 胸腔注射 自发性气胸 效果 

分 类 号：R563[医药卫生—呼吸系统]