茂菲氏滴管在大量胸腔积液持续控速引流中的临床应用研究  

Clinical Research of Murphy’s Dropper in Continuous Controlled Velocity Drainage of Massive Pleural Effusion

作　　者：沈毅 何弢 何柳 周云峰 Shen Yi;He Tao;He Liu(West China School of Public Health,Sichuan University/Department of Thoracic Surgery,West China Fourth Hospital of Sichuan University,Chengdu,Sichuan 610041;The Second Affiliated Hospital of Chengdu Medical College.Department of Thoracic Surgery,416 Hospital of Nuclear Industry,Chengdu,Sichuan 610057,China)

机构地区：[1]四川大学华西公共卫生学院/四川大学华西第四医院微创外科,四川成都610041 [2]成都医学院第二附属医院·核工业四一六医院胸外科,四川成都610057

出　　处：《四川医学》2020年第4期388-392,共5页Sichuan Medical Journal

摘　　要：目的将茂菲氏滴管与胸腔引流管结合,通过控制滴速来控制胸腔积液患者胸水的引流速度,并持续引流胸水;探讨此方法在大量胸腔积液患者诊治中的临床应用价值。方法纳入我院2017年6月至2019年5月期间初诊为大量胸腔积液的患者70例;根据患者的基线特征将其随机分成传统组和控速组。其中传统组34例,引流连接管采用传统连接管,并采用传统引流方式:第一天引流600mL,以后每日引流1000mL;控速组36例,采用带茂菲氏滴管导管的引流连接管,并采用持续控速引流:置管后持续引流,控制引流初始速度为90滴/分(20滴=1mL,即4.5mL/分钟)。比较两组患者引流相关指标及并发症发生率的差异。结果两组患者在基线特征、总引流量、穿刺点渗液发生率差异无统计学意义(P<0.05)。与传统组相比控速组的引流时间显著缩短,差异有统计学意义(P<0.05);引流相关费用显著降低,差异有统计学意义(P<0.05);堵管发生率也显著下降,差异有统计学意义(P<0.05)。两组患者在引流相关并发症方面比较均无统计学意义,但传统组复张性肺水肿发生率在数值上高于控速组。结论采用带茂菲氏滴管的引流管进行持续控速引流,可明减少引流相关费用,减少并发症,加速患者诊治进程;此方法具有良好的临床应用前景,值得临床推广。Objective To combine Murphy’s dropper with pleural drainage tube to control the drainage rate of pleural effusion in patients with pleural effusion by controlling the drip rate and continue to drain pleural effusion.To explore the clinical value of this method in the diagnosis and treatment of a large number of patients with pleural effusion.Methods We enrolled 70 patients who were newly diagnosed with a large amount of pleural effusion from June 2017 to May 2019 in our hospital,they were randomly divided into traditional group( TG) and control group( CG) according to their baseline characteristics.Among them,TG was 34 cases,the traditional connection tube was used for the drainage connection tube,and the traditional drainage method was used: the first day was 600 ml,and the daily drainage was 1000 m L;CG was 36 cases,a drainage connection tube with a Murphy dropper catheter was used,and continuous drainage was used: after the tube was placed,the drainage was continued,and the initial drainage rate was controlled to 90 drops/minute( 20 drops = 1 ml,or 4.5 ml/minute).The differences between the two groups of drainage related indicators and the incidence of complications were compared.Results There was no statistical difference between two groups of patients at baseline characteristics,total drainage volume,and incidence of effusion at the puncture point.Compared with TG,the drainage time of CG was significantly shortened( P<0.05),the drainage-related costs were significantly reduced( P<0.05),the incidence of tube blockage was also significantly reduced( P<0.05).There was no statistically significant difference in drainage-related complications,but the incidence of re-expansion pulmonary edema in TG was numerically higher than that in CG.Conclusion Using a drainage tube with Murphy’s dropper for continuous rate-controlled drainage could clearly reduce the drainage-related costs,reduce complications,and accelerate the diagnosis and treatment of patients.This method has good clinical application prospects and is

关 键 词：茂菲氏滴管 胸腔积液 控速引流 引流时间 并发症 

分 类 号：R561[医药卫生—呼吸系统]