胸腔闭式引流部位对自发性气胸患者疗效及术后并发症的影响  

The effect of closed thoracic drainage site on efficacy and postoperative complications in patients with spontaneous pneumothorax

作　　者：杨胜珍 陈文香 贾文晶 YANG Sheng-zhen;CHEN Wen-xiang;JIA Wen-jing(Department of Thoracic Surgery,Qingdao Jiaozhou Central Hospital,Qingdao 266300,China)

机构地区：[1]山东省青岛市胶州中心医院胸外科,山东青岛266300

出　　处：《实用医院临床杂志》2024年第4期75-78,共4页Practical Journal of Clinical Medicine

基　　金：山东省青岛市医药卫生科研项目(编号:2022-WJZD123)。

摘　　要：目的 探讨胸腔闭式引流部位对自发性气胸患者疗效及术后并发症的影响。方法 我院就诊的自发性气胸患者218例,依据区域随机化法分为观察组(腋前线第三肋间行胸腔闭式引流)及对照组(锁骨中线第二肋间行胸腔闭式引流)各109例,比较两组临床相关指标及并发症发生情况,于术前及术后7 d测定肺功能、动脉血气,于术前及术后6、12、24、48、72 h比较疼痛程度[视觉模拟评分法(VAS)量表]。结果 观察组并发症发生率低于对照组(P<0.05)。术后7 d,两组肺功能及动脉血气指标组间比较差异无统计学意义(P>0.05);观察组术后6、12、24、48 h的VAS评分均显著低于同期对照组(P<0.05)。术后72 h,两组VAS评分、临床相关指标比较差异无统计学意义(P>0.05)。结论 腋前线第三肋间及锁骨中线第二肋间胸腔闭式引流均对自发性气胸具有良好治疗效果,且疗效相似,但锁骨中线第二肋间胸腔闭式引流并发症发生风险更高,疼痛更为严重。Objective To explore the influence of closed thoracic drainage site on efficacy and postoperative complications in patients with spontaneous pneumothorax.Methods Two hundred and eighteen patients with spontaneous pneumothorax in our hospital were selected.The patients were classified into an observation group and a control group based on area randomization method,109 in each group.In the observation group,thoracic closed drainage was performed in the third intercostal space of the anterior axllary line.In the control group,closed thoracic drainage was performed in the second intercostal space of the midclavicular line.The clinical related indicators and complications were compared between the two groups.The lung function and arterial blood gas were measured before and after 7 days of surgery.The pain degree estimated by Visual Analogue Scale(VAS)was compared before and after 6,12,24,48 and 72 hours of surgery.Results The incidence of complications was obviously lower in the observation group(P<0.05).After 7 days of surgery,there was no significant difference in the lung function and arterial blood gas indicators between the two groups(P>0.05).The VAS scores in the observation group at 6,12,24 and 48 hours after surgery were significantly lower compared to the control group(P<0.05).No obvious differences were shown in VAS score and clinical indicators between groups after 72 hours of surgery(P>0.05).Conclusions Both closed thoracic drainages in the third intercostal space of the anterior axillary line and the second intercostal space of the midclavicular line have a good therapeutic effect on spontaneous pneumothorax.Both sites have similar efficacy.However,the second intercostal space of the midclavicular line has a higher risk of complications and more serious pain.

关 键 词：胸腔闭式引流 自发性气胸 并发症 疼痛程度 肺功能 

分 类 号：R655[医药卫生—外科学]