不同导管胸膜腔置管闭式引流治疗自发性气胸疗效比较  

Comparison of Curative Effect of Closed Drainage with Different Catheterized Pleural Cavity in Treatment of Spontaneous Pneumothorax

作　　者：李红义[1] 翟成凯[1] 曹臣龙[1] LI Hongyi;ZHAI Chengkai;CAO Chenlong(Xinxiang First People's Hospital,Henan Xinxiang 453000)

机构地区：[1]新乡市第一人民医院,河南新乡453000

出　　处：《深圳中西医结合杂志》2024年第3期97-101,共5页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的:比较不同导管胸膜腔置管闭式引流治疗自发性气胸疗效。方法:选取新乡市第一人民医院2018年9月至2023年9月收治的90例自发性气胸患者作为研究对象,应用随机数字表法将其分为三组,即中心静脉导管组、胸腔引流管组与三腔气囊导尿管组,各组均为30例。所有患者均采取胸膜腔置管闭式引流术进行治疗,三组患者分别采取中心静脉导管、胸腔引流管和三腔气囊导尿管进行引流。比较三组患者临床疗效,置管时疼痛发生率、置管时出血量、二次置管率与调整引流管率,平均切口大小、肺复张时间、置管时间、住院时间,术后疼痛程度,术后并发症发生情况。结果:胸腔引流管组和三腔气囊导尿管组的总有效率高于中心静脉导管组;中心静脉导管组和三腔气囊导尿管组患者置管时疼痛发生率、二次置管率与调整引流管率以及置管时出血量均明显低于胸腔引流管组;中心静脉导管组患者平均切口大小明显短于三腔气囊导尿管组和胸腔引流管组,且三腔气囊导尿管组短于胸腔引流管组;术后1 d、3 d、5 d,中心静脉导管组和三腔气囊导尿管组患者的视觉模拟评分法(VAS)评分明显低于胸腔引流管组,中心静脉导管组和三腔气囊导尿管组切口感染、肺水肿/皮下气肿、胸膜反应发生率明显低于胸腔引流管组;差异均具有统计学意义(P<0.05)。结论:采取胸腔引流管与三腔气囊导尿管进行胸膜腔置管闭式引流治疗自发性气胸疗效优于中心静脉导管,而应用中心静脉导管和三腔气囊导尿管患者置管时疼痛发生率较低,能够降低二次置管率、创伤性较低,降低术后疼痛程度,减少并发症发生率。Objective To compare the effect of different catheterized pleural cavity closed drainage on spontaneous pneumothorax.Methods A total of 90 patients with spontaneous pneumothorax admitted to Xinxiang First People's Hospital from September 2018 to September 2023 were selected as the research objects,and divided into three groups,namely,central venous catheter group,thoracic drainage catheter group and three-chamber balloon catheter group,with 30 cases in each group.All patients were treated with pleural catheter closed drainage,and the three groups had central venous catheter,thoracic chamber and three-chamber balloon catheter for drainage.The clinical efficacy of the three groups were compared,including the incidence of pain during catheterization,blood loss during catheterization,secondary catheterization rate and adjustment rate of drainage tube,the average incision size,lung reconstruction time,catheterization time,hospital stay time,postoperative pain degree,and the occurrence of postoperative complications.Results The total effective rate of the thoracic drainage catheter and the three-chamber balloon catheter group was higher than that of the central venous catheter group;The incidence of pain,secondary catheterization rate,adjusted drainage rate and the amount of bleeding in the central venous catheter group and the three-chamber balloon catheter group were significantly lower than those of the thoracic drainage catheter group;The mean incision size of patients in the central venous catheter group was significantly shorter than the three-chamber balloon catheter group and the thoracic drainage catheter group,and the three-chambe balloon catheter group was shorter than the thoracic drainage catheter group;postoperative 1 d,3 d and 5 d,the visual analogue scales(VAS)of patients in the central venous catheter group were significantly lower than those in the thoracic drainage catheter group.The incidence of incision infection,pulmonary edema/subcutaneous emphysema and pleural reaction in the central venous cath

关 键 词：自发性气胸 膜腔置管闭式引流术 中心静脉导管 胸腔引流管 三腔气囊导尿管 

分 类 号：R655[医药卫生—外科学]