老年胸腔积液病人穿刺引流后并发气胸的危险因素分析及预防对策分析  

Risk factors and preventive measures of pneumothorax in elderly patients with pleural effusion after puncture and drainage

作　　者：卢瑞琦[1] 孙燕川 郭昌[1] 杨泽西 徐海亮 宋建民[1] LU Rui-qi;SUN Yan-chuan;GUO Chang;YANG Ze-xi;XU Hai-liang;SONG Jian-min(The First Department of Respiratory and Critical Care Medicine, Baoding First Central Hospital, Baoding 071000, China)

机构地区：[1]保定市第一中心医院呼吸与危重症医学一科,河北省保定市071000

出　　处：《实用老年医学》2022年第2期177-179,共3页Practical Geriatrics

基　　金：保定市科技计划项目(1951ZF055)。

摘　　要：目的研究老年胸腔积液病人穿刺引流后并发气胸的危险因素及预防对策。方法以2018年1月至2019年12月在我院进行胸腔积液治疗的病人478例作为研究对象,发生气胸病人50例。对气胸组以及非气胸组病人的临床资料以及一般资料进行比较,分析老年胸腔积液病人穿刺引流后并发气胸的危险因素。结果气胸组的年龄高于非气胸组,BMI低于非气胸组(P<0.05)。2组穿刺时间>30 min、穿刺角度>30°、穿刺次数>3次、病灶大小<3 cm以及病灶深度>5 cm的病人比例差异有统计学意义(P<0.05)。Logistic回归分析显示,较高的年龄(OR=4.019,95%CI1.009~23.926)、穿刺时间>30 min(OR=14.089,95%CI2.002~67.065)、穿刺角度>30°(OR=13.020,95%CI2.006~56.930)、穿刺次数>3次(OR=10.320,95%CI2.223~53.987)、病灶大小<3 cm(OR=21.002,95%CI4.001~102.568)、病灶深度>5 cm(OR=10.564,95%CI2.335~55.974)均是造成病人气胸的危险因素。结论年龄、穿刺时间>30 min、穿刺角度>30°、穿刺次数>3次、病灶大小<3 cm以及病灶深度>5 cm均是造成老年胸腔积液病人穿刺引流后并发气胸的危险因素,建议临床通过技术革新以及对以上病人的早期干预,减少气胸的发生。Objective To study the risk factors and preventive measures of pneumothorax in the elderly patients with pleural effusion after puncture and drainage.Methods A total of 478 patients with pleural effusion treated in our hospital from January 2018 to December 2019 were selected as the research subjects,and 50 patients were complicated with pneumothorax.The clinical data and general data of pneumothorax group and non-pneumothorax group were compared,and the risk factors of pneumothorax in the elderly patients with pleural effusion after puncture and drainage were analyzed.Results The age of pneumothorax group(t=13.110,P<0.01)was significantly higher and the body mass index(t=2.079,P=0.043)was significantly lower than that of non-pneumothorax group.In the two groups,the ratios of patients with puncture time>30 min(χ2=19.552,P<0.001),puncture angle>30°(χ2=22.361,P<0.001),puncture times>3 times(χ2=22.571,P<0.001),lesion size<3 cm(χ2=16.921,P<0.001)and lesion depth>5 cm(χ2=9.621,P<0.001)between the two groups were statistically different.Multivariate Logistic analysis showed higher age(OR=4.019,95%CI1.009-23.926),puncture time>30 min(OR=14.089,95%CI2.002-67.065),puncture angle>30°(OR=13.020,95%CI2.006-56.930),puncture times>3 times(OR=10.320,95%CI4.223-102.987),the size of the lesion<3 cm(OR=21.002,95%CI14.001-102.568),and the depth of the lesion>5 cm(OR=10.564,95%CI2.335-55.974)were risk factors for pneumothorax.Conclusions The incidence of pneumothorax in elderly patients with pleural effusion after puncture and drainage is influenced by puncture time,puncture angle,puncture times,lesion size and lesion depth.It is suggested that the clinical technology innovation and early intervention for the above patients can further reduce the occurrence of pneumothorax.

关 键 词：老年人 胸腔积液 气胸 危险因素 

分 类 号：R561[医药卫生—呼吸系统]